RCM Collections Specialists

Description

RCM COLLECTIONS SPECIALIST – Positron Emission Tomography (PET) Scan Collections Specialist - Full-TIme

Capitol Imaging Services (CIS) has been in business since 1973. The company is a dynamic and growing company looking for an enthusiast and energetic candidate to add to the team. Our commitment to quality care and patient satisfaction means every member of our staff plays a vital role in a patient's journey towards healing.

CIS is currently looking for an experienced RCM Collections Specialist for the Capitol Billing Group (CBG) the Revenue Cycle team serving Capitol Imaging Services.  The PET RCM Collections Specialist will be responsible for the submission and reimbursement of billed claims.  Given the sophisticated nature of PET scanning technology and reimbursement, the candidate will be familiar with prior authorization requirements, correct billing set up and submission, insurer requirements for reimbursement, and knowledge of radiopharmacology reimbursement practices. 

This position will report into management of the Capitol Billing Group (CBG) office in Metairie, La.  This position can be remote and/or office based. 

Summary of Essential Position Requirements

• The candidate will participate in applicable pre-service activity to include establishing medical necessity, assisting prior authorization, patient benefit eligibility, reviewing all included services and radiopharmaceuticals, and ensuring proper claim setup to secure timely and correct reimbursement.
• This candidate will oversee and manage the daily collection and aging reports of patient & insurance charges. They will be responsible for timely claim filing and follow-up and will provide reports to management as necessary.
• Candidate will manage insurance, denial, profile variance, patient, and credit tickler file for PET claims.
• Reviews tickler files to identify past due accounts for follow-up activities. Reviews accounts to determine collection status. Contacts payers via phone or email to determine status of claims.
• Request additional information from patients, physician office, and others upon request from payors. Request rebills or corrected bills as needed from billing system. Files appeals and reconsiderations to insurance companies and government payers as needed to obtain correct payment on accounts.
• Demonstrates a thorough knowledge of CPT, Radiopharmaceutical drugs, ICD-10 codes, and Local Medicare Policy guidelines, as well as insurance contractual language regarding preferred provider organizations.
• Contacts patients regarding delinquent accounts and arranges mutually acceptable payment schedules.
• Demonstrates a special ability to deal with patients regarding sensitive financial matters and recaptures unpaid balances. Answer the phone and assist with billing questions.
• Ability to maintain the highest level of confidentiality.
• Experience with Medical Billing (Imagine) software is preferred.

Knowledge, Skills, & Abilities:

• Demonstration of critical thinking and organizational skills, illustrated by understanding billing requirements and solving payment delays and denials. 
• Skills in answering telephones, compiling statistics, inputting data in computerized software systems, maintaining filing systems, maintaining logs, researching information.
• Excellent communications skills, both verbal and written.
• Excellent time management
• Ability to manage multiple tasks concurrently.
• Good human relations skills

Requirements

Qualifications:

The ideal candidate must possess strong interpersonal and communication skills. The ability to be proactive and critically think ahead is imperative for this position. The candidate must also possess a sound working knowledge of cash management principles, accounting and AR related experience, and working knowledge of appropriate billing and collection cycles. They must ensure that procedures are followed and ethical standards for the follow-up of overdue accounts are maintained. They must manage the credit and collection principles, processes, regulations and standards. The ideal candidate will be proficient in the use of MS Office; expert in Microsoft Excel; excellent with spreadsheet and medical billing software applications. Candidate must possess the ability to process patients and agencies inquiries. They must be skilled in establishing and maintaining effective working relationships with other employees, patients, insurance carriers and the public. It is imperative that this candidate possess the ability to maintain confidentiality on all financial and sensitive information.

The PET technology is a unique and novel modality in diagnostic imaging.  The successful candidate will demonstrate an understanding of the specific claim submission, authorization, and reimbursement requirements.  The successful candidate will work closely with PET technologists, administrators for imaging centers, billing and coding leaders, collection leaders, and management to ensure successful reimbursement for costly services and radiopharmaceuticals.

Education and Experience:

• High school diploma
• Some college preferred.
• Minimum 2 years’ experience

General working hours: Monday - Friday 8 am-5 pm

CIS will offer competitive salary and benefits for the ideal PET RCM Collections Specialist: 

• Company provided life insurance, Short-term disability insurance.
• Additional optional employee, dependent and spouse Life and A D & D insurance
• Medical
• Dental
• Vision
• 401(K) with company match
• PTO – paid time off
• Paid holidays

If you have a proven track record of results and are looking to join a growing, forward-thinking organization, apply now.

Qualifications