Revo Health is a professional services company that partners with multiple healthcare groups to deliver exceptional patient care. The Billing & Denial Specialist is responsible for managing all aspects of accounts receivable billing for Ambulatory Surgical Centers, ensuring accurate claim processing and effective communication with patients and insurance providers.
Responsibilities
- Serve as the primary point of contact for patient and insurance inquiries related to receivables
- Monitor and take timely action on claims in the PMHST workflow queue
- Build and maintain collaborative relationships with ASC teams and affiliated physician groups
- Review and refile rejected claims as necessary
- Identify and resolve claim rejections using clearinghouse tools (Waystar and PMHST)
- Manage insurance denials through the workflow queue and denial management processes
- Conduct follow-up on unprocessed insurance claims
- Prepare and submit appeals for services that were not processed correctly
- Review aging reports with leadership to determine next steps for unresolved claims
- Communicate payer updates to leadership and team members
- Maintain working knowledge of CPT and ICD-10 coding guidelines
- Perform other duties as assigned
Skills
- High School Diploma or GED required
- Prior experience in health insurance billing is essential
- Adhere to company policies, procedures, and ethical standards
- Complete required training and comply with applicable laws and regulations (e.g., HIPAA, OSHA)
- Demonstrate reliable attendance and punctuality
- Work onsite during business hours and travel independently within the clinic, office, or surgery center
- Perform physical tasks such as bending, lifting, standing, and sitting for extended periods
- Manage workload efficiently, handle interruptions, and meet deadlines
- Communicate professionally and respectfully with patients, team members, and leadership
- Prioritize tasks and adapt to changing operational needs
- Apply logical reasoning to solve problems and follow instructions effectively
- Operate office equipment and phone systems proficiently
- Work independently with minimal supervision
- Travel to other work locations as needed
- Ability to comply with company policies, procedures, practices, and business ethics guidelines
- Ability to comply with all applicable laws and regulations, (e.g. HIPAA, Stark, OSHA, employment laws, etc.)
- Demonstrate prompt and reliable attendance
- Work at an efficient and productive pace, handle interruptions appropriately, and meet deadlines. Prioritize workload effectively
- Communicate respectfully and professionally in face-to-face, phone and email interactions
- Apply principles of logical thinking to define problems, establish facts, and draw valid conclusions
Benefits
- Employees working 30+ hours per week (60 hours per pay period) are eligible for our Medical (w/Maternity Bundle), Dental & Vision plans, as well as Tuition Reimbursement.
- All employees, regardless of hours, are eligible for 401(k) w/ Profit Sharing, Employee Assistance Program, Lifetime Fitness Subsidy, Car Rental discounts, Home, Auto, & Pet insurance savings programs & more.
Company Overview
Revo Health provides care bundle development, quality improvement, BPO, management services and ASC solutions for healthcare leaders. It was founded in 2017, and is headquartered in Minneapolis, Minnesota, USA, with a workforce of 201-500 employees. Its website is https://revohealth.com/.
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