Current Opportunities

Revenue Cycle Specialist

    • Job Tracking ID: 512915-602420
    • Job Location: Philadelphia, PA
    • Job Level: Mid Career (2+ years)
    • Level of Education: High School/GED
    • Job Type: Full-Time/Regular
    • Date Updated: October 12, 2020
    • Years of Experience: Any
    • Starting Date: ASAP
    • FLSA Status: Non Exempt
    • Job Status: Full Time
    • Department: Finance
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Job Description:

The Revenue Cycle Specialist will work as an integral part of an interdisciplinary team to support the goals and protocols of the revenue cycle workflow. The individual must be able to process large quantities of data in order to monitor key performance Indicators and research any and all barriers to successful revenue cycle management. The candidate must possess the ability to work independently and interchangeably across all MCO’s and workflows, with strong organizational, communication and interpersonal skills. 

Essential Functions:

  • Under the guidance of the Revenue Cycle Manager, Specialists will be responsible for various aspects of the entire revenue cycle, from scheduling to accounts receivable.
  • Working in conjunction with the Revenue Cycle Manager to complete all MCO care gaps and reporting requirements.
  • Support the Revenue Cycle Manager with appropriate coding and billing related functions as needed to support Spectrums third party billing company.
  • Use of MCO reports and practice registries to proactively identify patients due or over-due for specific health services, contacts the patients, motivates the patient to complete the recommendation, and assists in scheduling appointments. 
  • Responsible for contacting new and established members identified on the MCO listings and assure they are assigned to appropriate provider panels and schedule appointments using EMR system using patient demographic and insurance information as appointments are scheduled.
  • Obtains all necessary appointment information and assures patients are scheduled appropriately for evaluation, checking with clinical staff when necessary for guidance.
  • Monitor members to ensure that appointments are kept.
  • Identifies patients that are out of care or in are elsewhere and reports these patients to the MCO appropriately.
  • Perform other functions as necessary including ad hoc duties.
  • With the Revenue Cycle Manager, research and process claims billing data, analyzing trends and identifying areas for improvement. Communicate accordingly through prescribed avenues based on organizational policy and process.
  • Develop, process and maintain ongoing emergency room diversion lists that Spectrum receives from our hospital partners including contacting patients identified on the lists and scheduling appointments.
  • Identify improvement opportunities based on performance metrics and trends.
  • Remain flexible and adapt to changing MCO regulations and care gap protocols.
  • Provide all necessary reporting and data required by the Revenue Cycle Manager


Experience and Skills:

  • Medical Terminology certification is preferred
  • High School Diploma
  • Proficient with Microsoft word and excel
  • Comfort and flexibility working in a fast-paced health environment
  • The ability to sit for the majority of the work day
  • Proven track record of customer service skills


Competitive Compensation Package offered.