Division

Emory Healthcare Inc.

Campus Location

Atlanta, GA, 30345

Campus Location

US-GA-Atlanta

Department

EHI Precert

Job Type

Regular Full-Time

Job Number

160679

Job Category

Revenue Cycle & Managed Care

Schedule

8a-4:30p

Standard Hours

40 Hours

Hourly Minimum

USD $21.88/Hr.

Hourly Midpoint

USD $26.66/Hr.

Be inspired. Be valued. Belong. At Emory Healthcare

At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:

• Comprehensive health benefits that start day 1

• Student Loan Repayment Assistance & Reimbursement Programs

• Family-focused benefits

• Wellness incentives

• Ongoing mentorship, development, leadership programs

• And more

The Revenue Cycle Specialist is responsible for managing all aspects of the revenue cycle, including the resolution of patient claims, ensuring accurate billing, and maximizing reimbursement. This role serves as a patient advocate, supports financial processes, and contributes to overall operational efficiency and quality improvement.

RESPONSIBILITIES

Revenue Cycle & Claims Management

• Manage patient accounts across the full revenue cycle, ensuring timely resolution of all claims.

• Verify, research, and complete required documentation to submit claims for reimbursement.

• Analyze payments, identify variances, and resolve complex reimbursement issues.

• Ensure compliance with payer requirements, including pre-certifications and claim splitting.

• Maintain knowledge of managed care contracts and apply terms to billing and reimbursement processes.

Patient Financial Services

• Update and maintain accurate patient demographic and insurance information.

• Communicate financial policies to patients clearly and effectively.

• Identify patients needing financial counseling and provide appropriate resources.

• Support patients during and after care with billing, collections, and financial assistance.

• Serve as a patient advocate throughout the lifecycle of the account.

Account Follow-Up & Collections

• Collect and follow up on assigned accounts before, during, and after admission/discharge.

• Perform account reconciliation and ensure timely reimbursement.

• Resolve financial issues related to patient accounts using analytical and problem-solving skills.

Collaboration & Workflow Support

• Work closely with leadership to improve departmental workflows and processes.

• Assist with departmental operations and workflow needs as required.

• Serve as a resource and point of contact for staff questions.

• Support training and development of new team members.

Quality Improvement & Reporting

• Identify issues impacting revenue and notify leadership with recommended solutions.

• Contribute to quality assurance initiatives by reporting trends, denials, and improvement opportunities.

• Participate in education sessions and insurance payer forums to stay current on industry standards.

Specialized Knowledge & Compliance

• Maintain working knowledge of:

  • Insurance and reimbursement processes

  • Referrals and authorizations

  • Electronic Medical Records (EMRs) and financial systems

• Understand billing requirements for specialized services, including:

  • Transplants

  • Hospice

  • Infusions

  • Rehabilitation

  • Centers of Excellence

• (If applicable) Maintain knowledge of transplant care standards and donor/recipient phases.

General Responsibilities

• Operate effectively in a high-volume environment with heavy phone and computer usage.

• Demonstrate professionalism, organization, and strong communication skills at all times.

• Work independently while managing multiple priorities.

• Perform additional duties as assigned.

Required Skills & Competencies

• Strong analytical and problem-solving abilities

• Excellent verbal and written communication skills

• Proficiency in EMR systems, payer systems, and financial tools

• Ability to interpret and apply managed care contracts

• Strong organizational and time management skills

• Ability to work independently and collaboratively

MINIMUM QUALIFICATIONS

• Bachelor’s degree with two (2) years of relevant experience; OR

• Any equivalent combination of education and experience

Physical Requirements

Medium Work (Maximum 25 lbs):

• Lifting:

  • Up to 25 lbs occasionally (0–33% of the workday)

  • 11–25 lbs frequently (34–66% of the workday)

  • 1–10 lbs constantly (67–100% of the workday)

• Carrying objects up to 25 lbs

Work Activities:

• Occasional to frequent standing and walking

• Occasional sitting

• Frequent close visual work (computer use, typing, reading, writing)

Note: Physical demands may vary depending on assigned work area and specific job tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare’s Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.

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