Revenue Cycle Support Specialist The Revenue Cycle Support Specialist provides a wide range of tasks to support the daily operation. This role is responsible for managing, processing, and responding to all incoming and outgoing written communications related to the revenue cycle. This includes handling insurance correspondence, patient billing inquiries, claim follow-ups, denial management letters, and internal communications to ensure accurate, timely, and compliant resolution of revenue cycle issues.
Minimum Qualifications:
Education, Certification, and/or Licensure: 1. High school diploma or equivalent required.
Experience:
1. Correspondence processing. Preferred Qualifications Experience: 1. Knowledge of healthcare billing, insurance processes, and payer guidelines. 2. Experience with insurance denials, appeals, and claim resolution processes. Core Duties and Responsibilities 1. Receive, review, and process all incoming correspondence related to billing, insurance claims, denials, appeals, and patient inquiries. 2. Process outgoing mails including but not limited to claims, itemized bills and medical records as required. 3. Draft, edit, and send responses to insurance companies, patients, and internal departments following established guidelines and policies. 4. Maintain accurate records of all correspondence in electronic document management systems or revenue cycle software. 5. Track, monitor, and escalate unresolved correspondence issues to appropriate revenue cycle teams for resolution. 6. Collaborate with billing, coding, collections, and patient financial services teams to gather necessary information for correspondence responses. 7. Ensure all correspondence complies with HIPAA regulations and organizational confidentiality standards. 8. Support denial management by generating appeal letters and coordinating necessary documentation. 9. Assist in audit preparation by organizing correspondence records and documentation. 10. Maintain templates and update correspondence formats as needed to reflect current policies and payer requirements. 11. Provide regular reports on correspondence volume, status, and resolution metrics. 12. Other Revenue Cycle supporting tasks and duties as assigned.
Physical Requirements:
1. Must be able to sit for extended periods of time. 2. Must have reading and comprehension ability. 3. Visual acuity must be within normal range. 4. Must have manual dexterity to operate keyboards, fax machines, telephones and other business equipment. 5. Must be able to lift 50 pounds within handling package storage. 6. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping and feeling are necessary body movements utilized in performing duties throughout the work shift.
Working Environment: 1. Office type environment. 2. Home office.
Skills and Abilities:
1. Strong written communication skills with excellent grammar, spelling, and attention to detail. 2. Ability to manage multiple priorities and deadlines in a fast-paced environment. 3. Proficient in Microsoft Office Suite, especially Word and Outlook. 4. Strong organizational and record-keeping skills. 5. Understanding of HIPAA and patient privacy laws. Scheduled Weekly Hours: 40 Shift: Non-Exempt Company: SYSTEM West Virginia University Health System Cost Center: 663 SYSTEM Cash Management Address: 3040 University Ave, Morgantown, West Virginia Equal Opportunity Employer West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.
