Revenue Cycle Specialist

Job Responsibilities

The Revenue Cycle Specialist will be responsible for the review, analysis, trending, follow-up, and resolution of third-party claims reimbursements including the identification, billing, and collection of payments. The Revenue Cycle Specialist will actively engage with other departments to ensure timely resolution of all outstanding accounts to ensure maximum reimbursement.

• Knowledge of third-party claims reimbursement practices.
• Verify patient data required for billing
• Advanced knowledge of payer contracts, payment policies, regulations to ensure correct payment of claims.
• Thorough knowledge of complex insurance correspondences to include explanation of benefits, remittance advices and denial letters.
• Advanced understanding and ability to navigate payer websites and vendor applicable systems to verify insurance benefits, understanding insurance payments, denials and correspondences.
• Maintain established quality assurance and productivity benchmarks while utilizing best practice standards established.
• Accurately update accounts in all systems to reflect work being performed.
• Communicate identified payment trends to leadership promptly and accurately and provide solutions to resolve challenges and issues.
• Complete documentation and record requests
• Interact directly with patients regarding billing questions and payments
• Other duties as assigned

Education and Experience:

·         Familiarity with medical records and attorney requests a plus

·         3–5 years of medical billing knowledge required; anesthesia billing experience preferred

·         Attention to detail and accuracy is a must

·         Proficient MS Office skills, Intermediate excel skills

·         Excellent written communications and organizational skills

·         Outstanding telephone and people skills

·         Solid organization skills and ability to work independently

·         Flexible mentality; willing and capable of performing varied tasks and adapting to change

·         Able to work in a team environment

·         Professionally exercises discretion and independent judgment in day-to-day work

·         High school diploma or equivalent

Physical Requirements:

• The ability to sit and stand for long periods of time
• Must be able to reach, grasp, feel, and see up close and from afar
• Must be able to use basic office computer hardware and peripherals, with or without reasonable accommodation

Job Types: Full-time

Schedule:

• Day shift
• Monday to Friday

Work Location:

• One location

Work Remotely:

• No