Job Purpose and Position Overview:
Senior Specialist in IMS, eCW, Athena and Carecloud with expertise in charge posting, payment posting, AR management, patient statements, and reporting. Acts as a subject matter expert (SME) for the team, provides advanced support in resolving complex issues, mentors junior specialists, and ensures process excellence and client satisfaction.
Specific Job Duties/Responsibilities:
Oversee and validate charge posting, payment posting, AR follow-up, denial management, and reporting activities to ensure accuracy, compliance, and timely completion.
Handle complex client, payer, and operational escalations, providing timely resolution and recommendations for issue prevention.
Conduct root cause analysis of recurring denials, rejections, underpayments, and process discrepancies, and implement corrective actions to improve outcomes.
Monitor operational and revenue cycle performance metrics, ensuring adherence to quality, productivity, and service delivery standards.
Perform quality reviews, reconciliations, and audits to ensure compliance with payer regulations, client requirements, and organizational policies.
Act as a Subject Matter Expert (SME) for Cardiology revenue cycle processes, supporting team members with process-related guidance and issue resolution.
Mentor and train Specialists on process workflows, PMS applications, payer guidelines, and best practices to improve overall team performance.
Support onboarding and cross-training initiatives to enhance workforce flexibility and knowledge retention.
Collaborate with Team Leaders and Managers to identify process improvement opportunities, workflow enhancements, and automation initiatives.
Assist in the preparation of operational reports, performance dashboards, audit findings, and client-facing insights.
Support process transitions, new client implementations, and special projects as assigned.
Ensure compliance with HIPAA, ISMS, QMS, payer regulations, and client-specific requirements.
Skills Required
- Expertise in IMS, eCW, Athena, and CareCloud
- Experience with charge posting, payment posting, accounts receivable management, patient statements, and reporting
- Knowledge of Cardiology revenue cycle processes
- Ability to resolve complex client, payer, and operational escalations
- Experience with denial management, reconciliations, quality reviews, and audits
- Knowledge of HIPAA, ISMS, QMS, payer regulations, and client requirements
- Ability to mentor and train junior specialists
What We Do
Billed Right is a healthcare revenue cycle management company that helps medical practices improve financial performance through customized billing and RCM services. Its work spans insurance eligibility, charge posting, claim submission, denial management, payment posting, accounts receivable, reporting, and account management. Founded in 2006, the company focuses on solving healthcare organizations’ billing problems rather than simply selling products, emphasizing operational maturity, data-driven insights, and long-term client partnerships.
