Sr. Revenue Cycle Associate

Job Description

This position provides customer service to resolve patient billing concerns and responds to questions on accounts, insurance coverage, payment arrangements, and financial assistance. This role serves as a subject matter expert to Revenue Cycle Specialists.

Job Duties

• Ensures accurate and timely claim resolution.
• Affords assistance in analyzing claims resolution and provides feedback to management for solutions and process improvements.
• Performs follow up with insurance companies to ensure appropriate payment on claims, resolve denials, correct claims and appeal claims.
• Spools, edits and sends electronic and paper claims daily.
• Prepares and sends patient statement files daily.
• Utilizes work queues to review and analyze account balances in order to collect payment for outstanding balances, utilizes multiple system applications to review and update patient information, and to research and resolve outstanding AR balances.
• Accesses and understands the various online systems' processes in determining how a claim has been paid in order to accurately apply payments and adjustments and assist in determining the adjudication of funds.
• Posts payments and contractual adjustments via remits to accounts and posts payments to collection accounts reversing collection adjustments.
• Maintains deposit spreadsheet to reconcile cash with bank statements.
• Scans payment batches and mails daily.
• Communicates using form letters, email or internal correspondence to resolve patient inquiries and insurance issues.
• Documents accounts with clear and concise verbiage, and reviews and responds to correspondence and inquiries received.
• Sets up and monitors payment plans to facilitate payment of outstanding personal balances.
• Issues patient or insurance refunds as necessary.
• Contacts patients and guarantors to secure necessary billing information and patient payments on account, and verifies insurance eligibility.
• Acts as a liaison with clinic staff and patients providing assistance in claims and receivables resolution.
• Performs other duties as assigned.

Minimum Requirements

• A high school diploma or equivalent required.
• 3 or more years healthcare billing/claim experience required.
• Knowledge of ICD10 and CPT codes, customer service skills required, basic knowledge of medical billing terminology required.
• Intermediate skills with Microsoft Office products, data entry, 10 Key; excellent written and verbal communication skills; exceptional customer service skills; detail oriented; task oriented; fast paced.