Revenue Cycle & Billing Specialist

Revenue Cycle & Billing Specialist The Work Connection – Occupational Health

The Revenue Cycle & Billing Specialist is responsible for ensuring the integrity of The Work Connection's revenue cycle from charge review through payment posting and financial reporting. This position serves as the primary resource for billing accuracy, payment reconciliation, revenue reporting, and communication with providers, front office staff, finance, and third-party payers. The Revenue Cycle & Billing Specialist works to maximize reimbursement, ensure accurate billing practices, identify revenue opportunities, and maintain the financial integrity of the department.

Reports To: Director, Occupational Health / The Work Connection Essential Responsibilities Revenue Cycle Management Review and verify charges entered into the electronic medical record for completeness and accuracy. Identify and resolve charge entry discrepancies before invoices are generated. Ensure services are billed according to contracted pricing and established fee schedules.

Review daily work queues to ensure timely invoicing. Monitor the revenue cycle from charge entry through payment posting. Billing & Accounts Receivable Generate and review employer, Workman Comp, and patient statements.

Verify billing accuracy prior to release. Process billing adjustments, corrections, credits, and approved write-offs. Investigate rejected or returned invoices and coordinate appropriate corrections.

Work outstanding client balances monthly. Payment Posting & Reconciliation Post payments accurately from employers, self-pay clients, and third-party administrators. Reconcile daily deposits and payment batches.

Research and resolve payment variances and unapplied payments. Maintain accurate accounts receivable balances. Ensure payment activity aligns with financial records.

Work with Patient Accounts cash posters in determining appropriate posting of Workman’s Comp payments Revenue Integrity Perform routine audits to ensure documentation supports charges billed. Review billing trends to identify missed charges or revenue leakage. Work with providers and clinical staff to resolve documentation or charging questions.

Maintain pricing tables and special employer pricing as assigned. Assist with implementation of new billing workflows and process improvements. Financial Reporting Generate daily, weekly, monthly, and year-end revenue reports.

Prepare reports supporting reconciliation to the hospital general ledger. Monitor billing volumes, collections, accounts receivable, payment trends, and key performance indicators. Assist leadership with financial analysis and revenue forecasting.

Provide supporting documentation requested by Finance during month-end close. Customer & Client Support Serve as the primary billing resource for employer clients regarding s and account questions. Coordinate with Finance regarding deposits, reconciliations, and payment issues.

Communicate professionally with third-party administrators and employer representatives. Assist with setup and maintenance of employer billing profiles and special pricing arrangements. Compliance Maintain confidentiality in accordance with HIPAA and organizational policies.

Follow applicable federal and state billing regulations. Support internal and external audits as requested. Maintain accurate financial records in accordance with organizational standards.

Qualifications Education Associate degree in Business, Accounting, Healthcare Administration, or related field preferred. Equivalent experience may be substituted. Experience Minimum of three years of healthcare billing or revenue cycle experience.

Experience with occupational health, workers' compensation, or employer-based healthcare preferred. Experience posting payments and reconciling accounts. Experience generating financial and operational reports.

Electronic medical record experience required; Enterprise Health experience preferred. Knowledge, Skills & Abilities Strong understanding of healthcare revenue cycle processes. Knowledge of medical billing practices and reimbursement methodologies.

Excellent analytical and problem-solving abilities. Strong attention to detail and accuracy. Ability to reconcile financial information and identify discrepancies.

Proficiency with Microsoft Excel and reporting tools. Excellent organizational and time-management skills. Ability to communicate effectively with providers, finance staff, employers, and third-party payers.

Ability to manage multiple priorities while meeting deadlines. Performance Expectations The Revenue Cycle & Billing Specialist will: Maintain a high level of billing accuracy. Ensure timely payment posting and account reconciliation.

Produce accurate financial reports within established timelines. Identify opportunities to improve revenue capture and billing efficiency. Work collaboratively with clinical, operational, and finance teams.

Contribute to continuous process improvement within the revenue cycle. Key Measures of Success Billing accuracy Timeliness of charge review Payment posting turnaround time Accounts receivable aging Revenue reconciliation accuracy Timeliness of month-end reporting Reduction in billing errors and adjustments Employer and internal customer satisfaction