Revenue Cycle Specialists: Who are they, and what do they do?

Financially strong practices can withstand fierce competition and ever-changing healthcare dynamics. Today, a pandemic later, a realization has changed how practices see their revenue cycle. 

As of now, few roles are vital to the long-term financial integrity of any healthcare organization. People who can manage the revenue cycle are among those few. That is why practices are increasingly leaning towards a revenue cycle specialist to ensure financial viability. 

Who is a revenue cycle specialist?

A revenue cycle specialist is a financial expert who manages critical tasks in the healthcare business, such as payment and collections. Due to the sheer complexities of the industry, these experts frequently operate in hospitals or clinics, where they encounter numerous unique challenges.

For example, when services are billed, it is not always clear if patients can afford them. The same is valid for collecting payments from people who don’t have insurance or who have insurance but haven’t paid their expenses yet.

Moreover, credit card issuers may refuse to pay claims due to price disputes or other issues during processing, leaving revenue cycle specialists with little alternative but to keep trying until they are reimbursed.

What should a revenue cycle specialist be like?

A revenue cycle specialist must be knowledgeable about current business processes and technologies. Since most businesses work digitally, knowledge of all the latest software and apps utilized in this area is essential.

Although revenue cycle experts deal with numbers and finances more than most individuals, they must also have excellent interpersonal skills that allow them to connect with others. They must also speak clearly and effectively to convey detailed information.

Revenue cycle specialists are typically expected to have an associate’s degree in finance or business management. However, the American Healthcare Professional Specialists Association (AHPSA) can potentially provide revenue cycle specialists with extra certification. 

Required skills of an efficient revenue cycle specialist

• Work ethic

Having a solid work ethic cannot be taught. One of the most critical attributes for potential new hires is being a hard worker because they will be committed to getting the job done and doing it effectively.

• Team player

A billing and collections staff member must be a people person. This position necessitates regular interactions with other members of the center and patients. Therefore they must be a people person.

• Communication skills

Working as a revenue cycle specialist needs interaction with a wide range of people, making communication skills vital. It is essential to communicate effectively and enable communication across the various departments of the ASC and with patients.

• Passion for the sector

To ensure that your new worker does high-quality work, they should genuinely be interested in the healthcare sector, particularly the revenue cycle. Employing someone with such zeal might offer you confidence that they will view this as a long-term opportunity and will likely seek to advance within your firm.

• Professional/academic accomplishments

While prior billing and collections expertise in an ASC setting is undoubtedly beneficial, it isn’t always a deal-breaker. If this is the case, look for educational or professional successes, such as awards, goals met, or promotions, that demonstrate they are hardworking, devoted, and eager to learn.

• Tech-savvy

General computer skills and the capacity to learn rapidly are two more attributes that any effective revenue cycle professional should have. Billing and collections personnel are no longer operating on the same IT platform. 

It is now critical that potential new workers understand how to use various computing tools and apps, including Microsoft Office Suite and the latest revenue cycle management software. In these programs, an ever-expanding amount of work is now done, in addition to improved billing & collections and analytics platforms.

Why does a practice need a revenue cycle specialist?

Revenue cycle specialists are hired to “plug in the gaps” in the financial operations of a hospital or clinic. Their purpose is to ensure that all aspects of billing and budgeting work properly, whether they are accounting for patient treatments, estimating the cost of patient intake, providing bills for payment by the patient & their insurance company, or collecting past-due commitments. 

As hospitals and clinics rely on outstanding balance collections to sustain their operations, supervision of these procedures and their accompanying departments is critical for long-term viability.

Find your revenue cycle specialist and more.

It is hard to run a practice and find the right people. Spending time and resources only to find unsuitable hires can pull you down. But do you need to go through all this when you can outsource?

Capline services are one of the best revenue cycle management companies in the US. We are a team of more than 400 professionals equipped with the best skills and expertise to accelerate your growth tremendously. 

Contact us to bring on board the best revenue cycle management healthcare team to take care of your operational and backend worries. Call us now.