Job Summary: Revenue Cycle Specialist will conduct daily interactions in a manner that demonstrates a positive and organized attitude and effectively models the organizations service philosophy and values. They will be responsible for verifying that all processes are completed efficiently and completely. Ensure compliance with HIPAA privacy standards.

Job Qualifications:

• High school graduation or proof of GED
• Strong skills in working with computers and communication equipment
• Skills in establishing and maintaining effective working relationships with staff members and clients/Physicians
• Retina billing experience required
• Ability to accurately resolve claims and client concerns
• Knowledge of medical billing and coding terminology
• Knowledge of computer software programs including: Word, Outlook, EMR, Selected facility software system
• Strong organizational skills and keen attention to detail
• Must be motivated
• Must be dependable

Mental / Physical Demands:

• Stamina to work in a fast paced and demanding environment
• Mental alertness and critical thinking skills
• Medical/clinical billing background preferred
• Professional and supportive attitude to patients, co-workers, and all customers of the organization
• Requires the ability to stand, sit, bend, reach overhead, and carry 20 pounds if necessary

Responsibilities:

Including but not limited to:

• Claims clarifications (pre and post submission, including CPT and ICD10 appropriateness)
• Monitoring providers’ timely completion of progress notes and billing
• Accessing and navigating payer websites and online tools (SPOT, Availity, NaviNet, etc.)
• Reviewing payer policies for updates
• Submitting escalated corrected claims and appeals
• Assist with processing paper claims/secondary claims
• Assist with processing unidentified payments/obtain EOBs
• Responsible for Entire Billing Process from Insurance Verifications to Collections.
• Coordinates with billing team to get detailed information on Charges, Payments, Pending Clarifications, Correspondence, AR Outstanding addressed by Analyst and Callers.
• Conducts weekly AR meeting with practice manager to go over the issues on collections.
• Training new staff for the team
• Reviewing Practice Management, Drugs P/L and AR compilation reports periodically.
• Maintaining effective communication with the practice through Phone and email to sort all day-to-day issues.
• Empowering the team with adequate knowledge and strategically focusing on increasing the revenue of the practice.
• Participating in all the training sessions organized by practice and insurance.
• Additional duties or projects as assigned by Revenue Cycle Manager or Director

General Duties:

• Maintains an atmosphere that supports customer service and client satisfaction.
• Displays positive level of enthusiasm and interest about their job and the company.
• Assumes responsibility for continually increasing knowledge and skills pertinent to the position.
• Willingly takes on additional assignments and responsibilities.
• Shows initiative.
• Frequently suggests positive solutions to improve service to patients and the operation of the company.
• Demonstrates an understanding of practice philosophy in patient care.
• Works cooperatively with others.
• Complies with standards of conduct and supports ethical practices as indicated in compliance plans.
• Prioritizes work responsibilities and completes assignments in a timely fashion.
• Ability to multi-task.

Job Type: Full-time

Pay: competitive compensation

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• ICD-10: 2 years (Required)
• Retina billing/AR follow up required

Work Location: In person and/or Remote