Revenue Cycle Specialist

Company Description

Human Services Management Corporation (HSMC) provides shared business and consulting services to both non-profit and proprietary human services agencies. These services include accounting, payroll, third party billing and collections, human resources, online and live Continuing Education, marketing, facility development and quality assurance programs.

Job Description

The Revenue Cycle Specialist is a multi-specialized role responsible for supporting all aspects of the revenue cycle, including cash posting, insurance coordination, and billing functions. This position ensures the accurate and timely processing of payments, verification and authorization of insurance coverage, and submission and follow-up of claims. The Specialist works collaboratively across departments to resolve reimbursement issues, maintain compliance, and support the organization’s financial performance.

Responsibilities:

Cash Posting & Reconciliation:

• Post payments, adjustments, and denials to patient accounts accurately and timely
• Perform daily and monthly reconciliation of cash receipts and postings, identifying and resolving discrepancies

Insurance Coordination & Authorizations:

• Verify patient insurance eligibility, benefits, deductibles, co-pays, and authorization requirements
• Obtain and track prior authorizations, ensuring all required clinical documentation is complete and accurate

Billing & Accounts Receivable Support:

• Prepare, review, and submit accurate insurance claims with appropriate coding and documentation
• Monitor and follow up on outstanding claims and accounts receivable

Collaboration & Compliance:

• Collaborate regularly with the Client companies, Intake, Billing, and Collections teams to resolve reimbursement issues
• Ensure all activities comply with HIPAA and organizational privacy and security policies

Qualifications

• High School Diploma or equivalent required; Associate's degree preferred
• 2 years’ experience with automated systems and multiple electronic reimbursement processes
• Experience with cash posting, billing procedures and accounts receivable
• Knowledge of CPT and ICD-10 coding and medical terminology preferred
• Proficiency with practice management systems, EHR platforms, and Microsoft Excel

*Please note that this is a hybrid position requiring (3) days per week in the office (Milford). 

Additional Information

Please visit our website at www.hsmc.org to learn more about our organization!

Selection for employment is made regardless of race, color, religion, creed, sex, sexual orientation, gender identity/expression, pregnancy or pregnancy-related condition, marital status, national origin, ancestry, age, disability, handicap, genetic information, someone who is a member of, applies to perform, or has an obligation to perform, service in a uniformed military service of the United States, including the National Guard, on the basis of that membership, application or obligation; veteran status, or any other bases protected by law.  HSMC participates in E-Verify.

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