Revenue Cycle Specialist II

Description

Neighborhood Outreach Access to Health (NOAH) is a non-profit Federally Qualified Health Center (FQHC) that provides comprehensive, integrated, and affordable high-quality healthcare services to underserved populations. We provide comprehensive care to over 40,000 neighbors including medical, dental, behavioral health, psychiatric, nutrition, pharmacy services, preventive health, eligibility assistance, and health education programs. NOAH embraces all people, and we respect everyone for who they are.  We firmly believe that diversity is our strength and stand firmly committed to the principles of Justice, Equity, Diversity, and Inclusion.

Job Summary:

The Revenue Cycle Specialist II position will be responsible for collecting outstanding accounts receivable from insurance carriers and patients.

Duties/Responsibilities:

• Prepare and process insurance claims timely and accurately to government, commercial and managed care payers.

• Review and distribute corrected claims.

• Enter appropriate account notes in billing system to clarify actions taken to reconcile claims.

• Resolve claim edits via claim edit work queues.

• Verify eligibility for coverage via multiple payor websites

• Identify and resolve patient account billing concerns, requests, and complaints.

• Investigate and review all outstanding A/R accounts to ensure prompt and proper payment.

• Answer account questions from insurance companies and patients.

• Contact insurance carriers to obtain status of unpaid, pending, and denied claims.

• Identify denial trends and communicate back to supervisor.

• Review and resolve accounts with credit balances.

• Research and determine root cause of denial and pursue proper course of action to resolve, as well as to follow-up and obtain payment.

• Review and follow-up on incoming insurance and patient correspondence.

• Escalate claim issue(s) to Supervisor as appropriate.

• Assist with special projects as directed by Supervisor / Manager.

• Maintain strict confidentiality, adhering to all HIPAA guidelines and regulations.

• Receive and process patient credit card payments.

• Participates in accounts receivable collections projects as needed to meet department goals.

• Sets up payment plans for patients.

• Processes payments and correspondence received in the central business office; processes EFT/ERA, lockbox, mail, POS, and phone payments.

• Performs daily batch reconciliation.

• Attends, participates, and/or assists in meetings, trainings, community outreach activities, continuing education opportunities, and other activities as required.

• Performs other related duties as assigned.

Qualifications

Required Skills/Knowledge/Abilities: 

• Knowledge of medical terminology used in medical billing, current office practices and procedures, and basic math.

• Ability to elicit and evaluate information, sometimes of a highly personal and sensitive nature, from a broad spectrum of individuals and agencies.

• Ability to maintain confidentiality.

• Ability to read, interpret, and apply regulations, policies, and procedures.

• Ability to work with minimal supervision and with extensive detail, and to prepare written correspondence using correct grammar, punctuation, and spelling.

• Ability to coordinate functions and work cooperatively with others.

• Ability to use and access database computer applications.

• Ability to organize work and set priorities to meet deadlines.

• Knowledge of payment posting and balancing to batch totals and deposits.  

• Knowledge of or ability to learn procedure and disease codes used in medical billing.

• Knowledge of fiscal recordkeeping using an automated system and/or healthcare billing.

• Knowledge of methods for qualifying for funding; collection laws, regulations, and techniques.

• Ability to convince debtors of the necessity of assuming financial responsibility, and to explain the financial impact of various alternatives.

• Effective interpersonal skills, including the ability to promote teamwork

Education and Experience:

• High School Diploma or GED required.

• Certificate in Medical Billing strongly preferred.

• Associate’s Degree in Business, Finance, Health Information Management, or a related field preferred

• EPIC experience preferred.

• 2 years of healthcare billing and/or collections experience required; medical office setting preferred.

Other Requirements:

• New Hires are required to pass pre-employment background check and drug testing (effective 11/1/2022).