Revenue Cycle Manager

We are looking for a Revenue Cycle Management Specialist. Must be experienced in Physicians Group Collections. Reports to the Director of IRCM.

Benefits of the RCM Specialist

As a full time, RCM Specialist you will be offered the following benefit options:

• Medical

• Dental

• Vision

• Supplemental Life

• Disability

• 401k

• Personal PTO

• Vacation Time

• Employee Assistance Program

Requirements of the RCM Specialist:

Under the direction of the Director of IRCM, the RCM Specialist ensures timely submission, reimbursement, and claim follow-up of professional medical claims to insurance companies.

This position is ideal for candidates seeking a full time-time position. M-F

Qualifications/Skills

• Minimum of 5 years of experience in healthcare billing, collections for addiction/behavioral health treatment center

• Knowledge of insurance guidelines

• Competent use of computer systems, software, and 10 key calculators.

• Familiarity with CPT, ICD-10 Coding, and ASAM criteria

• Effective communication abilities for phone contacts with insurance payers to resolve issues

• Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds

• Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion

• Problem-solving skills to research and resolve discrepancies, denials, appeals, collections. A calm manner and patience working with either patients or insurers during this process

Essential Job Function of the RCM Specialist

• Prepare, key, and review claims prior to reconciliation

• Processes claim corrections identified from the reconciliation

• Experience with coding, CPT/HCPC, Revenue, and Diagnosis codes

• Experience with 1500 HCFA and UB04 claim forms

• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing

• Through billing software, review claim rejections and correct errors, and rebill claims

• Following up on unpaid claims within the standard collection cycle timeframe

• Checking each insurance payment for accuracy and compliance with contract and usual and customary charges

• Calling insurance companies regarding any discrepancy in payments and underpayments

• Calling insurance companies for payment on open/unpaid claims

• Identifying and billing secondary or tertiary insurances

• Reviewing accounts with balances to identify next steps, including balances needing to be set as “collections” for balance due patient

• Responding to Refund Requests/Medical Records Requests

• Researching and appealing denied claims

• Answering patient or insurance telephone inquiries pertaining to assigned accounts

• Transferring Patient collection calls to the designated department