What are the responsibilities and job description for the Revenue & Recovery Specialist I position at Public Hospital District 3 of Grant County WA?
JOB SUMMARY
The Revenue & Recovery Specialist I is a key position in the Revenue Cycle, responsible to maximize the organizations cash flow by prompt and efficient collections of Accounts Receivable. Manage claims processes including accurate and timely claim creation, denial management and claim adjudication. Expected to have excellent follow up with providers and insurance companies to resolve issues, maintain aged accounts, payment posting, collections, customer service, and refunds.
DUTIES AND ESSENTIAL JOB FUNCTIONS
- Perform daily, systematic reviews of unpaid, underpaid, and denied accounts from the appropriate third-party payer source ensuring that accounts are paid and or resolved within timely filing limits.
- Identifies and analyzes insurance payments to determine the reason for discrepancies, process denials and appeals, and ensures payments received are paid per the contracts and within timely filing limits.
- Ensures appropriate information and correspondence is documented in accounts. Documenting information such as communication with the patient or payor, an explanation of payment, and denials or rebill.
- Runs reports, manages work queues daily, and resolves denials to maintain assigned patient accounts. Maintains accounts aging over 90 days to goal of 10%-15% of gross accounts receivable.
- Works credit balance work queues and reports to process refunds.
- Accurately posts patient and non-AR payments and adjustments, balances bank deposit for accounting department, and assists to ensure all cash accounts are reconciled daily.
- Reviews remittance advices to make sure the account has been properly credited.
- Collaboratively works with others to ensure undistributed cash issues are resolved timely.
- Meet productivity goals/benchmarks as set by the Director for the department.
- Serve as the primary customer service representative for payer and patient inquiries, responds to all calls with professionalism, and transfers calls appropriately. Responsible to track and resolve all issues timely.
