Revenue Cycle Specialist - Appeals

Essential Duties And Responsibilities

• Prepare and submit all billings expeditiously.
• Respond to phone and mail inquiries from Medicare.
• Conduct all follow-up activities including handling all correspondence for appeals and fair hearings.
• Process all denials to maximum benefit.
• Adhere to all company policies and procedures.
• Assure that customer problems are handled properly and promptly.
• Process and review assigned queues on a daily basis.
• Review and advise Medicare Supervisor of any and all changes in Medicare regulations or requirements and any issues related to Medicare billing.
• Input claim data information on a daily basis.
• Balance journals periodically.
• Ensure compliance of guidelines provided by Government related agencies and Corporate policies.
• Pass Quality Assurance audits with an accuracy rate of 95% or better.

Minimum Qualifications

• Minimum of one (1) year prior office work experience
• Minimum of one (1) year Medical Billing Experience
• Experience with ambulance coding and appeals is highly preferred
• Knowledge of HCPCS is preferred
• Prior work experience performing Medicare billing, follow-up, and knowledge of Medicare terminology is highly preferred
• Involvement with Medicare, Medicaid, HMO, and PPO appeals process if preferred
• General working knowledge of PCs and/or patient accounting computer systems
• Computer experience and proficiency using Microsoft Office Suite (Word, Excel, etc.), Adobe, and smartsheets
• Experience with website navigation
• Must type a minimum of 45 wpm and use a ten-key calculator by touch
• Working knowledge of medical terminology and ICD-9 and 10 coding
• Able to perform duties within tight time constraints and handle large volumes of work
• Able to work cooperatively in a team atmosphere

Education

• High school diploma or GED required
• College courses in psychology, communications, business, and/or health services is preferred