Revenue Cycle Specialist
Position Summary
Under direct supervision of the Worker’s Comp Manager, this position is responsible for assuring timely collection of accounts receivable, monitoring account activity and providing adequate follow up to ensure maximum reimbursement is received for physician billing.
Key Responsibilities
Performing collection activities, such as status calls to ensure timely reimbursement, appeals and account review.
Ensuring appropriate information is submitted to insurance companies in order to expedite payment.
Taking appropriate follow up actions on accounts to ensure claims are paid on the first follow-up call or appeal.
Determining that appropriate information is submitted to insurance companies in order to expedite payment.
Following up on assigned cases from within the organization.
Reviewing pre-bill claim holds to verify that the claim goes out clean the first time.
Composing appeals to insurance carriers for denied claims.
Handling incoming calls for information requests from insurance companies within 24 hours.
Assisting Financial Counselors when patients have questions regarding claims.
Correcting accounts that are billed to incorrect insurance companies.
Ensuring authorizations are attached to claims.
Communicating with the lead, supervisor and team to advise of trends, issues discovered.
Assure compliance with all company plans, policies and procedures set forth by the Florida Orthopaedic Institute.
Qualifications
High School Diploma or general education degree (GED)
2 – 4 years of physician office billing and denial management experience required
Basic Understanding of ICD10, CPT HCPCS
Ability to read and interpret explanation of benefits (EOBs)
4+ years of experience with worker’s compensation and commercial insurance products
Familiar with CMS 1500
Basic understanding of medical terminology and anatomy
Athena experience strongly preferred
Excellent communication skills both written and verbal
Self-starter that is detail oriented and capable of multi-tasking
Comprehensive knowledge of computer skills including Microsoft Office Suite
Comfortable in a fast-paced working environment of a growing practice
All candidates will be required to undergo pre-employment drug screening and/or be subject to random drug testing in accordance with applicable laws and company policy.