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What Does a Revenue Cycle Specialist Do?

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If you’re in the healthcare industry, you’ve likely heard of the revenue cycle specialist before, but what exactly does it mean?

Revenue cycle management refers to the collection of processes and procedures from when your patient walks into your office until they pay their bill, typically around 30 days after the service date. 

However, If you’re considering becoming a specialist in this field, let this guide answer all your questions about career options, salary, education, and more.

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What Is a Revenue Cycle Specialist

A Revenue Cycle Specialist is a person who manages a company’s revenue cycle. 

The individual analyzes past patient data to determine the best way to collect money from patients. 

They also negotiate with third-party payers on behalf of the healthcare provider to get the most money for their services. 

These professionals also review bills submitted by providers for payment from insurance companies or government programs. 

In some cases, they can be responsible for preparing annual financial statements and generating revenue reports.

Job Description

The job description of a revenue cycle specialist is to monitor patient data from admission to discharge. 

They are responsible for maintaining patient accounts to ensure the hospital receives its money for services rendered. 

Revenue cycle specialists must know any documentation or legal requirements to avoid fines or penalties. 

They need to be knowledgeable about insurance coverage, coding guidelines, and Medicare/Medicaid regulations. 

They also need strong communication skills to communicate with other departments effectively.

Most In-Demand Skills

As a revenue cycle specialist, you will be responsible for the financial management of a healthcare organization. 

This includes patient billing, insurance claims processing, and collections. You will need strong analytical skills to succeed in this role. 

Additionally, you will need to communicate effectively with patients and insurance companies. Excellent customer service skills are essential in this role. 

Finally, you must work well under pressure and handle difficult situations.

Educational Requirements

To become a professional in this field, you will need a high school diploma or equivalent. 

However, many employers prefer candidates who have completed some post-secondary education, such as a certificate or associate degree program in medical billing and coding.

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Revenue Cycle Specialist Salary & Outlook

Revenue cycle specialists’ salaries vary by experience level. Entry-level revenue cycle specialists can earn between $42,000 and $60,000 annually.

Experienced revenue cycle specialists may earn between $75,000 and $95,000 per year. 

According to the Bureau of Labor Statistics (BLS), jobs in this field are expected to grow by 11% by 2026.

How to Become a Revenue Cycle Specialist

To become a revenue cycle specialist, you must work with healthcare providers on the day-to-day operations. 

These may include reconciling insurance claims and processing payments. 

You can also assist with analyzing financial data and providing clinical or operational performance reports. 

Training in healthcare management, accounting, business administration, information technology, or finance is also required for this position.

How Long to Become One

Those interested in becoming revenue cycle specialists should have at least a bachelor’s degree in business or a related field. 

However, many employers prefer candidates with master’s degrees. Becoming a revenue cycle specialist typically takes two to four years of experience working in healthcare administration or billing and coding.

Benefits of Working as a Revenue Cycle Specialist

The following are the benefits of working as a revenue cycle specialist

  • A RCS may be eligible for various health care plans 
  • They can help to reduce or manage risk for their organization 
  • Revenue specialists may be able to contribute new ideas for cutting costs or improving efficiency 
  • They may have opportunities to advance in their field 
  • They may be eligible for bonuses based on performance 
  • A professional credential (Certified Professional Coder) is available from AAPC (American Academy of Professional Coders).

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Conclusion

A revenue cycle specialist is a crucial position in any organization. They are responsible for ensuring that all revenue is collected and accounted for. 

This includes working with customers to set up payment plans, issuing invoices, and collecting payments. 

An RCS typically earns a salary of $50,000-$60,000 per year, and their job growth is expected to rise by 11 percent before 2026, so this is a great career path to venture into.

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