REVENUE CYCLE SPECIALIST I - New Paltz Family Center

About the role

The Revenue Cycle Specialist I is responsible for supporting the collections of accounts receivable. They maintain a thorough understanding of designated accounts and ensure their smooth operation through proper follow-up and adherence to policies and procedures.

Responsibilities

• Maintains complete understanding of designated accounts.
• Affirms the smooth operation of designated accounts receivable through proper follow-up and adherence to existing policies and procedures for the assigned area.
• Reviews and processes correspondence on a daily basis.
• Reviews and processes Explanation of Benefits for designated accounts and posts payments and denials accurately upon receipt.
• Provides clerical support to senior representatives such as mailing paper claims, preparing spreadsheets for appeals, or maintaining data spreadsheets as directed by the manager (s).
• Communicates to management information related to changes required for designated areas to facilitate the collection of accounts receivable.
• May be responsible for specific Aged Accounts Receivable’s on a weekly basis to ensure that designated accounts are processed timely.
• Verifies eligibility and performs data entry of patients’ personal/insurance information as needed to assist in payment of debt for designated accounts.
• Responds to incoming telephone, mail and email and Epic CRM inquiries from patients, providers and payers regarding outstanding balance.
• Interacts with other departments, insurance companies, medical professionals and patients on a daily basis.
• Recognizes issues relating to claims denials and communicates such information in a timely manner to the manager of the billing department.
• Maintains familiarity with the Institute fee schedules as well as CPT and ICD-10 coding; keeps up to date on annual changes.
• May be responsible for Claim Printing/Reviewing of printed claim forms for accuracy to ensure claims are paid timely.
• Maintains patient/employee confidentiality in the management of protected information.
• May be responsible for the submission of electronic claim and/or patient statement files depending on designated accounts receivable.
• May post charges or payments as assigned without automatic electronic assistance.
• Facilitate the collections of patient due balances through applicable collections processes.
• May be asked to participate in new staff orientation to familiarize them with procedures and policy updates as deemed necessary.
• May be asked to assist with special projects.
• Participates in the department’s performance improvement activities.
• Maintains patient/employee confidentiality in the management of information.
• Observes the Health Care System’s compliance policies.

Qualifications

• High School Diploma or GED required.
• Associates degree in business, accounting or healthcare preferred.
• Medical Billing & Coding or Medical Administrative Assistant Certifications preferred.
• Minimum of 3-6 months related office experience in a business office.