Revenue Cycle Billing Specialist

Responsibilities

• Monitor and follow up on outstanding Professional Billing (PB) and Hospital Billing (HB) claims via phone, payer websites, and Epic work queues.
• Investigate and resolve unpaid, underpaid, and rejected claims by working with insurance providers and internal departments.
• Analyze account history in Epic to determine appropriate next steps for claim resolution.
• Submit reconsiderations and appeals for PB and HB claims with necessary clinical justification and documentation.
• Navigate payer portals (such as Availity and NaviMedix) to verify claim status and obtain EOBs.
• Maintain accurate and detailed documentation of all follow-up activities in compliance with HIPAA and regulatory standards.

Requirements

• High school diploma or equivalent.
• 2+ years of experience in healthcare revenue cycle, claims processing, or AR follow-up.
• Demonstrated experience with both PB (CMS-1500 / 837P) and HB (UB-04 / 837I) claim follow-up.
• Proficiency with Epic billing modules and work queues.
• Ability to interpret EOB, ERA (835), and remittance advice data.
• Knowledge of 837P and 837I transaction sets.

Preferred Qualifications

• Associate’s or Bachelor’s degree in Health Information Management, Business, or a related field.
• Familiarity with Medicaid, Medicare, and commercial payer requirements.
• Experience with CARC/RARC denial and adjustment reason codes.

Benefits

• Medical insurance
• Vision insurance
• Dental insurance
• 401K
• Paid Time Off

About the Company

Firstsource provides business process management services, helping organizations optimize their operations through specialized expertise in revenue cycle management and digital transformation.