What are the responsibilities and job description for the Revenue Cycle Specialist – Claim Processing position at MAX Surgical Specialty Management?
Join Max Surgical Specialty Management, an innovative leader in the healthcare industry, as we embark on an exhilarating journey of growth and expansion!
We are seeking a motivated and dynamic individual to join our Revenue Cycle Management Team as a Revenue Cycle Specialist – Claim Processing.
What You'll Do:
The Revenue Cycle Specialist – Claim Processing is responsible for ensuring the accuracy and efficiency of insurance claim submissions, optimizing revenue cycles while maintaining exceptional service standards. By leveraging expertise in billing and accounts receivable management, the position supports timely payment collection, resolves claim discrepancies, and fosters transparent communication with stakeholders, contributing to the financial success and operational excellence of the organization.
The successful candidate will be able to:
Established in September 2022 as the Northeast region’s first oral and maxillofacial surgery-only specialty platform, MAX Surgical Specialty Management is a surgeon-led management services organization developed with clinical and surgeon autonomy at its core. Today, MAX supports surgeons across New Jersey, New York, Pennsylvania, Vermont and Connecticut, enabling practices to channel resources, skills and knowledge within the oral surgery specialty, leading industry advancements and delivering the highest standard of patient care. Surgeons have access to a curated network that allows them to collaborate with and work alongside a diverse pool of highly skilled peers who are leaders in their specialty. MAX safeguards surgeons’ independence while offering robust support systems, access to advanced technology and opportunities for financial growth.
Integrity-driven. Patient-focused. Experience the difference at www.max-ssm.com.
MAX Surgical Specialty Management is an equal opportunity employer committed to providing fair employment opportunities regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, veteran status, or any other legally protected characteristic. We welcome diversity and encourage applicants from all backgrounds. Our inclusive environment values and empowers every employee to contribute to our mission.
We are seeking a motivated and dynamic individual to join our Revenue Cycle Management Team as a Revenue Cycle Specialist – Claim Processing.
What You'll Do:
The Revenue Cycle Specialist – Claim Processing is responsible for ensuring the accuracy and efficiency of insurance claim submissions, optimizing revenue cycles while maintaining exceptional service standards. By leveraging expertise in billing and accounts receivable management, the position supports timely payment collection, resolves claim discrepancies, and fosters transparent communication with stakeholders, contributing to the financial success and operational excellence of the organization.
The successful candidate will be able to:
- Review and monitor all claims queues for assigned offices
- Examine patients’ chart in the queue, verifying demographic, insurance, and subscriber details for data accuracy
- Research all information needed to complete billing processing
- Post any corrections to claims to ensure integrity of account information
- Review claim submission reports to ensure claims were submitted and accepted by clearing house
- Work clearing house rejections and resubmit claims with corrections
- Run daily system charge error report and make necessary corrections to submit a clean claim
- Maintains a good working knowledge of the specific billing requirements for all payers
- Assign appropriate CDT, CPT codes and appropriate ICD- 10-CM diagnosis codes selecting the codes that accurately describe the condition for which the service or procedure was performed
- Review claim editing reports for consistent errors and follow up with the management for improvement in quality and performance
- Review patient demographics and Insurance make any corrections necessary before claim submission
- Confirm both Dental and Medical insurances have been verified, and the system reflects any chances necessary
- Validate claims address and electronic payer ID are correct in the system, check insurance cards to ensure the correct plan is selected
- Work with front office staff regarding any information missing in patients’ accounts that is needed for claims submission (e.g., insurance details, subscriber info, biopsy reports, etc.)
- Gather all necessary documents and images needed to create required attachments for claim submission
- Configure scans to panoramic x-rays as needed for claim submission
- Respond to insurance-related phone calls and return patient voicemails
- Compile daily reporting excel sheets to send to the manager weekly
- Run and save Claims Status, Transmission Log, and Claims Submission reports daily
- Perform any and all other duties as assigned
- High School Diploma required, Medical Billing and/or Coding Certification highly preferred
- 3 years of hands-on experience in healthcare revenue cycle management, with a proven track record of optimizing processes
- Proficient in all Microsoft Office applications as well as medical office software
- Proven experience in healthcare billing
- Sound knowledge of health insurance providers
- Strong interpersonal and organizational skills
- Excellent customer service skills
- The ability to work in a fast-paced environment
- Highly competitive salaries & annual performance and compensation reviews
- Competitive health insurance and benefits, including medical, dental, vision, disability, and more
- 401k retirement savings plan that includes employer match
- Generous Paid Time Off, sick leave, and paid holidays
- Advance your career growth with opportunities in the most extensive growing oral surgery practice in the Northeast
Established in September 2022 as the Northeast region’s first oral and maxillofacial surgery-only specialty platform, MAX Surgical Specialty Management is a surgeon-led management services organization developed with clinical and surgeon autonomy at its core. Today, MAX supports surgeons across New Jersey, New York, Pennsylvania, Vermont and Connecticut, enabling practices to channel resources, skills and knowledge within the oral surgery specialty, leading industry advancements and delivering the highest standard of patient care. Surgeons have access to a curated network that allows them to collaborate with and work alongside a diverse pool of highly skilled peers who are leaders in their specialty. MAX safeguards surgeons’ independence while offering robust support systems, access to advanced technology and opportunities for financial growth.
Integrity-driven. Patient-focused. Experience the difference at www.max-ssm.com.
MAX Surgical Specialty Management is an equal opportunity employer committed to providing fair employment opportunities regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, veteran status, or any other legally protected characteristic. We welcome diversity and encourage applicants from all backgrounds. Our inclusive environment values and empowers every employee to contribute to our mission.
