The Revenue Cycle Specialist (RCMS) is a multidisciplinary role within the Department of Medicine's Billing Office that combines work across three key revenue cycle functions: coding/auditing, charge entry, and payment posting.
The role is responsible for abstracting and coding notes and encounters, entering patient demographics and insurance information, entering professional charges, and posting and reconciling payments in the professional billing system for services rendered by Department of Medicine physicians and advanced practice providers.
The RCMS ensures that all information entered in the professional fee billing system is accurate and complete, and supports the billing office with other duties as assigned.
Essential functions
- Work across 3-4 clinical disciplines and prioritize areas of greatest need and focus.
- Navigate complex disciplines with multiple locations, billing areas, and special workflows.
- Select appropriate procedural and diagnostic codes based on provider documentation using HIPAA standardized code sets and CMS/payor guidelines.
- Ensure teaching physician documentation and billing requirements are met and clearly reflected.
- Review provider coding and provide training and feedback on coding questions and issues.
- Collaborate with the accounts receivable team on denials and charge correction requests as needed.
Education and experience
- High school diploma or GED preferred.
- Certified Professional Coder (CPC) or Certified Professional Coder-Apprentice (CPC-A).
- Two or more years of experience in a medical billing office.
- Experience resolving claims edits preferred.
Knowledge and skills
- Proficiency with PC applications, including Microsoft Office.
- Knowledge of Athena, GE, IDX, Epic, or similar computerized billing systems.
- Knowledge of payers in the specialty.
- Knowledge of ICD-10 and CPT coding.
- Understanding of FSCs used in Athena/GE/IDX systems, contractual requirements, and compliance with government billing regulations.
Location
Baltimore, Maryland, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 months ago