Summary:

The Revenue Cycle Specialist (Self-Pay) is responsible for collecting unpaid balances on delinquent medical accounts to ensure complete resolution of the account in an efficient manner. They will utilize excellent customer service and communication skills to proactively seek all avenues to collect outstanding debts, following established guidelines and procedures.

Role and Responsibilities: 

• Provides patients with respectful and courteous customer service
• Makes inbound and outbound calls with patients for outstanding balances
• Handles returned mail and/or bad addresses
• Reviews & prepares collection-eligible accounts for physician review; follows up on accounts accordingly 
• Sends accounts to external collection agency as needed
• Interacts with patients, staff and payers to answer account questions; obtains information needed to resolve issues
• Ensures that the patient balances are accurate by reviewing EOBs and insurance payments
• Communicates with patients and insurance companies to resolve outstanding balances (COB issues)
• Establishes payment plans and financial assistance for patients with outstanding balances
• Maintains open, positive and team-oriented lines of communication with management and staff members
• Contributes to the team through positive attitude, respectful interaction and innovative ideas
• Ensures that self-pay accounts are always handled in a customer service-oriented manner
• Performs ad-hoc duties and projects as assigned

Essential Qualifications:

Education: High School Diploma or equivalent; Bachelor's degree preferred.

Experience: 3-5 years experience in a medical billing specialist/accounts receivable role; Back-end billing experience within Ophthalmology preferred but not required.

Knowledge/Skills/Experience:

• Excellent problem-solving skills
• Outstanding listening skills
• Knowledge of ICD-9, ICD-10, CPT codes and procedures
• Ability to work independently and to work collaboratively on projects
• Ability to interface with management an co-workers
• Ability to create channels of communication to obtain information necessary to perform job tasks, such as with clients, payers, clinical staff and billing department staff
• Ability to recognize individual and system problems and to communicate such information to the supervisor
• Excellent written and verbal communication skills
• Outstanding attention to detail and excellent time management skills
• Outstanding computer skills with billing software, Microsoft Word and Microsoft Excel, able to learn our system, good typing skills
• Ability to work with proprietary information, PHI, ePHI, etc., while maintaining confidentiality at all time

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