What does a revenue specialist do?
A revenue specialist is in charge of overseeing and processing payments for their company, ensuring accuracy and timeliness. Their responsibilities revolve around reviewing invoices and insurance claims, monitoring tax deductions and expenses, liaising with external parties, collecting payments, producing progress and revenue reports, and maintaining records of all transactions. Furthermore, as a revenue specialist, it is essential to devise strategies for managing revenues, all while upholding the company's policies and regulations, including its vision and mission.
Revenue specialist responsibilities
Here are examples of responsibilities from real revenue specialist resumes:
- Process account receivables, charge entry, claims, and reimbursement in adherence to Medicare and all HMO guidelines.
- Establish a strong understanding of ICD-9 diagnosis and medical inventory codes.
- Work claim edits to ensure clean claim billing to Medicare/Medicare HMO's.
- Review the complex medical records and accurately codes primary/secondary diagnoses and procedures using ICD-10-CM and CPT coding conventions.
- Initiate appeals and ensure required documentation are submitted in the appeals process.
- Complete appeals when authorization are not obtain and or unusual procedure are performed.
- Audit billing, coding and clinical documentation to ensure compliance with Medicare and Medicaid regulations.
- Maintain strict confidentiality of documents and comply with HIPAA regulations stipulate by the facility and government.
- Identify admission process issue at single site where patients admit to observation when provider notes indicate inpatient admission.
- Review claims information such as diagnosis, medical reports and other documentation to determine Medicare's conditional payment.
- Verify and accurately enter all pt information verify Medicare benefits as well as Illinois Medicaid reconcile payments for monthly billing
- Facilitate follow-up on all deny claims, post Medicare payments, and review all documentation submit electronically to Medicare.
- Assist in completion of necessary applications for financial assistance, and refer qualifying patients to appropriate resources for financial guidance.
- Update MSP file to prevent delay in claims processing.
- Maintain a working knowledge of the federal MSP liability laws, guidelines and regulations.
Revenue specialist skills and personality traits
We calculated that 17% of Revenue Specialists are proficient in Patients, Revenue Cycle, and CPT. They’re also known for soft skills such as Analytical skills, Detail oriented, and Organizational skills.
We break down the percentage of Revenue Specialists that have these skills listed on their resume here:
- Patients, 17%
Assist in completion of necessary applications for financial assistance, and referred qualifying patients to appropriate resources for financial guidance.
- Revenue Cycle, 13%
Led and facilitated Asset Revenue Cycle Process improvement initiatives as needed.
- CPT, 6%
Verify correct ICD-9 and CPT codes for a variety of specialties *Work Individual portfolio of accounts from CCS Medical billing/collection system.
- Data Entry, 5%
Reviewed monthly reports for data entry accuracy and billed Medicare and Third Party Insurance
- Medical Terminology, 5%
Performed secretarial duties using specific knowledge of medical terminology and hospital, clinic and laboratory procedures.
- Medicaid, 5%
Verified and accurately entered all pt information verified Medicare benefits as well as Illinois Medicaid reconciled payments for monthly billing
"patients," "revenue cycle," and "cpt" are among the most common skills that revenue specialists use at work. You can find even more revenue specialist responsibilities below, including:
Analytical skills. To carry out their duties, the most important skill for a revenue specialist to have is analytical skills. Their role and responsibilities require that "tax examiners and revenue agents must be able to identify questionable claims for credits and deductions and determine if claims are lawful." Revenue specialists often use analytical skills in their day-to-day job, as shown by this real resume: "analyze and verified accounts receivable requests -researched all correspondence associate with assigned accounts, including eob's and documentation letters. "
Detail oriented. Another soft skill that's essential for fulfilling revenue specialist duties is detail oriented. The role rewards competence in this skill because "tax examiners and revenue agents verify the accuracy of each entry on the tax returns they review." According to a revenue specialist resume, here's how revenue specialists can utilize detail oriented in their job responsibilities: "developed detailed balance due notices for residents resulting in increased immediate payments reducing phone calls and visits to the business office. "
Organizational skills. This is an important skill for revenue specialists to perform their duties. For an example of how revenue specialist responsibilities depend on this skill, consider that "tax examiners and revenue agents may work with multiple returns and a variety of financial documents." This excerpt from a resume also shows how vital it is to everyday roles and responsibilities of a revenue specialist: "performed all revenue management activities for the company as outlined in the revenue & compliance management department organizational chart. ".
Interpersonal skills. A commonly-found skill in revenue specialist job descriptions, "interpersonal skills" is essential to what revenue specialists do. Revenue specialist responsibilities rely on this skill because "tax collectors must be comfortable interacting with people. when pursuing overdue accounts, tax collectors should be firm and composed." You can also see how revenue specialist duties rely on interpersonal skills in this resume example: "developed lasting client relationships by applying effective communication and interpersonal skills in resolving problems and responding to customer inquiries. "
Math skills. While "math skills" is last on this skills list, don't underestimate its importance to revenue specialist responsibilities. Much of what a revenue specialist does relies on this skill, seeing as "tax collectors and revenue agents deal with numbers daily and must be comfortable with arithmetic." Here is a resume example of how this skill is used in the everyday duties of revenue specialists: "use complex math equations to determine leak adjustment refunds for accidental excess water/sewer usage. "
The three companies that hire the most revenue specialists are:
- Legacy Health17 revenue specialists jobs
- McKinsey & Company Inc17 revenue specialists jobs
- Catholic Health East12 revenue specialists jobs
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Compare different revenue specialists
Revenue specialist vs. Tax examiner
A billing representative assists with the overall operations of the organization's billing department. Billing representatives post payments timely on the database, update account statements, generate financial reports, release invoices, and resolve account discrepancies. They also perform client accounts reconciliation as needed, monitor account receivables, review overdated balance, and notify clients of payment updates to ensure accurate and timely billing. A billing representative must have strong analytical and communication skills to manage clients' accounts, as well as comprehensive knowledge on the accounting industry to explain the payment terms and policies of an organization to a client.
These skill sets are where the common ground ends though. The responsibilities of a revenue specialist are more likely to require skills like "patients," "revenue cycle," "cpt," and "data entry." On the other hand, a job as a tax examiner requires skills like "business tax returns," "tax accounts," "technical assistance," and "provide technical assistance." As you can see, what employees do in each career varies considerably.
Tax examiners really shine in the government industry with an average salary of $50,077. Comparatively, revenue specialists tend to make the most money in the manufacturing industry with an average salary of $44,321.The education levels that tax examiners earn slightly differ from revenue specialists. In particular, tax examiners are 4.0% more likely to graduate with a Master's Degree than a revenue specialist. Additionally, they're 0.5% more likely to earn a Doctoral Degree.Revenue specialist vs. Tax compliance representative
A Tax Compliance Officer works for the IRS. This office primarily focuses on whether businesses and individual are making their necessary tax payments. Looking after the business reported revenue and paid taxes are the functions of the Tax Compliance Officer.
While some skills are similar in these professions, other skills aren't so similar. For example, resumes show us that revenue specialist responsibilities requires skills like "patients," "revenue cycle," "cpt," and "data entry." But a tax compliance representative might use other skills in their typical duties, such as, "customer service," "business tax returns," "securities," and "property tax."
In general, tax compliance representatives achieve similar levels of education than revenue specialists. They're 2.4% more likely to obtain a Master's Degree while being 0.5% more likely to earn a Doctoral Degree.Revenue specialist vs. Billing representative
There are many key differences between these two careers, including some of the skills required to perform responsibilities within each role. For example, a revenue specialist is likely to be skilled in "revenue cycle," "cycle management," "home health," and "management system," while a typical billing representative is skilled in "customer service," "icd-10," "outbound calls," and "patient billing."
Billing representatives make a very good living in the technology industry with an average annual salary of $35,295. On the other hand, revenue specialists are paid the highest salary in the manufacturing industry, with average annual pay of $44,321.Most billing representatives achieve a similar degree level compared to revenue specialists. For example, they're 3.1% less likely to graduate with a Master's Degree, and 0.2% less likely to earn a Doctoral Degree.Revenue specialist vs. Tax compliance officer
Types of revenue specialist
Updated January 8, 2025
