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Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

About the Role:

Job Summary

Rev Cycle Specialist II handles complex account follow-up, denials, and claims resolution, working more independently and applying advanced knowledge of payer rules and billing systems.

Minimum Job Qualifications

• Licensure or other certifications: GA HMFA Certified Patient Account Representative (CPAR) Certification (or must obtain with 6 months of hire)
• ​Educational Requirements: High School Diploma or GED
• Minimum Experience: Minimum 3 years hospital or professional billing/collections experience.
• Other: Strong understanding of payer policies, explanation of benefits interpretation, and patient accounting systems.

Preferred Job Qualifications

• Preferred Licensure or other certifications:
• Preferred Educational Requirements:
• Preferred Experience:
• Other:

Job Specific and Unique Knowledge, Skills and Abilities

• Solid knowledge of Revenue Cycle functions, including registration, authorization, and insurance billing.
• Personal computer proficiency to include all programs necessary to perform job duties and ability to toggle between systems efficiently.
• Excellent listening and problem-solving skills with attention to details.
• Excellent customer service skills and ability to remain calm and professional in stressful situations.
• Excellent verbal and written communication skills.
• Ability to work independently within guidelines.

Essential Tasks and Responsibilities

• Review, resubmit, and follow up on complex insurance claims.
• Perform detailed account research and update account information accurately.
• Resolve denials and ensure adherence to payer contract requirements.
• Maintain work queues and ensure timely resolution of accounts.
• Provide support to teammates and cross-train in additional revenue cycle functions.
• Demonstrate strong documentation, analytics, professionalism, and customer service.

Physical Demands

• Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time
• Weight Carried: Up to 20 lbs, Occasionally 0-30% of time
• Vision: Moderate, Occasionally 0-30% of time
• Kneeling/Stooping/Bending: Occasionally 0-30%
• Standing/Walking: Occasionally 0-30%
• Pushing/Pulling: Occasionally 0-30%
• Intensity of Work: Frequently 31-65%
• Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding

Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. 

NGHS: Opportunities start here.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.