Revenue Cycle Specialist

Duties/Responsibilities

• Determine client benefits to include co-pay and deductible amounts and provide information to Care Coordinator to ensure compliance with Company collection policy.
• Perform regular account analysis on all accounts to ensure billing is accurately captured for all clients.
• Proactively analyze A/R aging report, maintaining detailed collection notes on account status; effectively communicate issues in a timely and concise manner to client and management.
• Engage with clients/contractors/providers to clarify billing/coding/claims concerns, and correct deficiencies.
• Create detailed client encounter reports that support charges.
• Review the explanation of benefits (EOB) for patterns of rejected claims and provide training or other solutions to minimize such patterns going forward.
• Research denied claims. Determine and complete appropriate resolution process.
• Maintain a working knowledge of payer guidelines regarding timely filing, appeals and corrected claims to ensure compliance.
• Perform daily reconciliations.
• Assist with training new team members.
• Cool billing and collection activities.
• Manage outstanding client accounts and initiate follow-up efforts as needed.
• Manage outstanding insurance accounts and initiate follow-up efforts as needed.
• Evaluate billing processes and procedures and make suggestions for process improvement.
• Perform other duties as assigned.

Education and Experience

• Associates degree or equivalent relevant experience required.
• Bachelor’s degree preferred.
• Certified Professional Coder designation, or equivalent professional certification, is preferred.
• 2+ years’ experience with healthcare billing/full revenue cycle experience, including all major third-party payors billing.
• Demonstrated knowledge of regulatory guidelines and requirements for collections.
• Experience with psychiatric or other telemedicine is strongly preferred.
• Behavioral Health experience preferred.

Required Skills

• Skilled at negotiation and conflict resolution with multiple types of individuals, including patients and insurers.
• Working knowledge of medical terminology and anatomy.
• Strong attention to detail and accuracy.
• Compliance-focused.
• Strong organizational skills and the ability to work on deadlines.
• Must be able to work independently without supervision.
• High integrity with excellent problem-solving abilities.
• Excellent written and verbal communication skills with an emphasis on customer service.
• Ability to operate a personal computer and proficient with Microsoft Office Suite and medical office software, including electronic medical record software.
• Understanding and commitment to appropriate protection of confidential client information.

Physical Requirements

• Ability to alternate between sitting and standing for extended periods of time.
• Ability to move about inside the office to perform job responsibilities.
• Ability to operate a computer and/or laptop.
• Ability to effectively communicate with clients, team members, customers and clearly express oneself while exchanging information.
• Ability to read, write, and comprehend through listening.
• Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state, and local standards.

Benefits

• A healthy & positive atmosphere where everyone is valued.
• Schedule: Monday - Friday, 8AM-5PM CST
• Salary: $22.00 - $25.00 / hour