Revenue Cycle Specialist at Adobe Care And Wellness LLC

Livingston, Tennessee, United States -

Full Time

Start Date

Immediate

Expiry Date

04 Jan, 26

Salary

0.0

Posted On

06 Oct, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Accounts Receivable, Billing, Revenue Cycle Management, ICD-10 Coding, CPT Coding, Claim Submission, GAAP Principles, Analytical Skills, Organizational Skills, Problem-Solving Skills, Communication Skills, Customer Service, Attention to Detail, Adaptability, Professionalism, Teamwork

Industry

Hospitals and Health Care

Description

ABOUT ADOBE Adobe Population Health (APH) is a women-owned health solutions company founded in 2018 committed to positively impacting the lives we touch. The company has a culture of inclusivity and human kindness, based in Phoenix, AZ, with satellite locations in multiple states. APH has been recognized the last two years as one of “America's Fastest-Growing Private Companies” by Inc. 5000 and has earned a "Best Places to Work" award from the Phoenix Business Journal four years in a row. As one of the country's few fully integrated healthcare providers, APH offers a range of services which include case management, in-home/in-clinic wellness assessments, preventative care, transitional care, and social work services. APH offers customized services for Medicaid, Medicare, and the ACA/Marketplace lines of business.  POSITION PURPOSE The Revenue Cycle Specialist role is central to ensuring accurate, efficient, and compliant management of the revenue cycle for medical services that directly support population outcome management, complex respiratory management, enhanced respiratory care, quality enhancement initiatives, and remote monitoring. The Revenue Cycle Clerk will be responsible for billing and payment processes, including submitting claims, reconciling accounts, monitoring denials and rejections, and applying payments. Acting as a key liaison between clinical operations, coding, finance, and payers, this position ensures financial accuracy while supporting our mission of delivering accessible, high-quality respiratory care. DUTIES & RESPONSIBILITIES Managing Claims * Submit, monitor, and manage claims through the clearinghouse to ensure timely reimbursement. * Review and resolve claim errors, denials, and rejections; resubmit corrected claims using appropriate ICD-10and CPT codes. * Work collaboratively with the IT team to update and maintain billing records, clearinghouse integrations, and EHR-related billing workflows. * Partner with the coding team to verify coding accuracy and identify trends in claim denials. * Assist in implementing process improvements that reduce errors, increase claim acceptance rates, and shorten reimbursement cycles. Reporting & Reconciling * Reconcile revenue cycle data between the EHR, clearinghouse, and accounting systems (Sage Intacct) to ensure accuracy and completeness. * Prepare, maintain, and analyze aging reports, denial reports, and revenue cycle KPIs. * Generate reconciliations between claims submitted to health plans and payments received to proactively identify discrepancies. * Provide reporting support to leadership regarding payer performance, outstanding claims, and collections trends. * Communicate clearly and effectively with payers and internal stakeholders to resolve discrepancies or inquiries. Invoicing & Collections * Generate and send invoices for non-claim services (e.g., events, special programs, or contracts). * Accurately apply payments, adjustments, refunds, and write-offs against open invoices. * Track outstanding balances and escalate issues when necessary to minimize days in accounts receivable. * Collaborate with payers and patients (as applicable) to resolve billing disputes in a professional manner. Other Duties * Maintain compliance with HIPAA, HITECH, federal, state, and payer regulations. * Participate in staff training, process updates, and internal audits. * Perform other clerical and administrative support duties as assigned to assist the finance and population health teams. SKILLS & QUALIFICATIONS * Three (3+) years of experience in accounts receivable, billing, or revenue cycle-related roles. * One (1+) year of healthcare or medical billing experience required. * Experience working with Change Healthcare, Salesforce, and Sage Intacct highly desirable. * Knowledge ofICD-10, CPT coding, and claim submission best practices. * Strong working knowledge of GAAP principles related to accounts receivable and revenue recognition. * Excellent analytical, organizational, and problem-solving skills with meticulous attention to detail. * Ability to work independently, prioritize effectively, and meet deadlines in a fast-paced healthcare environment. * Strong written and verbal communication skills; able to interact with payers, patients, and internal teams in a professional and customer-centric manner. * Commitment to confidentiality and data protection in compliance with HIPAA and other regulations. * Proactive, adaptable, and flexible mindset with curiosity to identify and recommend process improvements. * Knowledge of regulatory frameworks and HIPAA-compliant data handling practices is helpful. * AAPC Certified Professional Coder (CPC)required. * AAPC Certified Professional Biller (CPB)strongly preferred. EDUCATION, LICENSES, & CERTIFICATION * High school diploma or GED required. * Associate’s degree in accounting, healthcare administration, or related field preferred. * AAPC Certified Professional Coder (CPC)required. * AAPC Certified Professional Biller (CPB) strongly preferred. * Additional revenue cycle or healthcare finance certifications are a plus. * A combination of equivalent education and professional experience may be considered in lieu of formal education requirements. BENEFITS & TOTAL REWARDS * Paid Orientation and Training * Insurance – Medical, Dental, Vision, and Life * 401k Plan – 3% match * Employee Assistance Program * Tuition Reimbursement * Continued Education Support * Mileage Reimbursement (if applicable) * Referral Bonuses * Paid Holidays (9days) * Paid Time Off (15 days) * Paid Volunteer Hours  CHARACTER & COMPETENCIES * Courage– To have the courage to the right thing at the right time. * Ownership– To take ownership of every issue you touch. * Respect– To respect yourself, co-workers, and for those whom you care. * Excellence– To be excellent in all that you do. * Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce. * Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethics; Upholds organizational values. * Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events. * Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments. * Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. * Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions. * Problem-Solving -Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem-solving situations; Uses reason even when dealing with emotional topics. * Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments. * Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed. PHYSICAL DEMANDS & WORK ENVIRONMENT * Occasionally required to stand. * Occasionally required to walk. * Continually required to sit. * Occasionally required to climb, balance, bend, stoop, kneel, or crawl. * Continually required to talk or hear. * While performing the duties of this job, the noise level in the work environment is usually moderate. * May occasionally lift and/or move more than 30 pounds. * Must be able to physically perform the essential duties of the position which include lifting 30 lbs., transporting materials, stooping, kneeling, crouching, reaching, use of hands, balancing, walking, standing, talking, hearing, and typing. EQUAL EMPLOYMENT OPPORTUNITY APH is an Equal Opportunity Employer where all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Responsibilities

The Revenue Cycle Specialist is responsible for managing billing and payment processes, ensuring accurate claims submission, and reconciling accounts. This role acts as a liaison between clinical operations, coding, finance, and payers to ensure financial accuracy and support high-quality respiratory care.