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Revenue Management Specialist-Remote

Company:
Spartanburg Regional Medical Center
Location:
Spartanburg, SC, 29306
Posted:
September 18, 2025
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Description:

Job Requirements Position Summary 100% Remote Applicants must reside in one of the following states: AL, AZ, CT, DE, FL, GA, IN, KS, KY, LA, MD, MI, NC, PA, RI, SC, VA, WV, or WI.

The AR management specialist works with unique department billing/collection functions to assure accounts are managed accurately and timely.

Responsibilities will vary based on department need.

Minimum Requirements Education * High School Diploma or equivalency Experience * 4 years medical office or medical billing in a hospital or physicians billing setting, collections or coding experience.

* Must possess strong knowledge of CPT, HCPCS and ICD-9/10 codes.

* Must be efficient in reading insurance explanation of benefits (EOB) and understanding of remittance and remark codes.

* Good working knowledge of Microsoft Excel * Good communication skills and the ability to interact well with multiple departments/levels of management License/Registration/Certifications * N/A Preferred Requirements Preferred Education * N/A Preferred Experience * In depth knowledge of all payer billing and eligibility requirements Preferred License/Registration/Certifications * Certified Procedural Coder (CPC) (CPC-H) * Certified Revenue Cycle Associate (CRCA) * Certified Medical Insurance Specialist (CMIS) * Registered Health Information Technician (RHIT) Core Job Responsibilities * Responsible for research and resolution of all outstanding patient and insurance credit accounts, any additional A/R management research and account updates required to ensure claims are filed to the appropriate carrier or posted correctly.

* Processing of all refunds or credit reversals in a timely manner as defined within the departmental credit/refund policy/procedures.

* Responsible for all government monthly credit reporting preparation and requirements * Responsible for accurate charge capture, charge review, claim edits, posting to the AR system and resolution of all charge edits.

* Responsible to handle all denials related to charge capture for improved integrity of charge capture * Responsible to accurately update patient demographics, insurance registration information, verification of insurance, etc.

* Responsible for the consolidation of duplicate guarantor/patient accounts within the AR management system in an accurate/timely manner.

* Responsible for the review and processing of Accounts Receivables reports to ensure revenue integrity.

Reporting trends identified during the analysis.

* Responsible to research and complete a detailed analysis of all payer variances based on our Contract modeling within our AR system.

* Revenue Management Specialist must have the skill set and understanding of payer and government payer contracts/schedules in order to confirm expected reimbursement amounts are correct.

* Work closely with other departments on revenue integrity issues including variance contract build issues, charging issues, A/R type issues and other items as define.

* Responsible for all account financial changes and refiling of those claims to the appropriate payer source.

* Assist with payer/physician credentialing and system table management.

* Responsible for electronic remittance, eligibility and claims agreements to insure the proper processing of electronic transactions, electronic remittance requirements and other payer requirements for billing.

* Responsible for the processing of all vendor claim updates, returns and resubmissions for payment.

* Other duties as assigned.

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