Description

The Revenue Cycle Management (RCM) Collections Specialist performs a wide variety of insurance billing duties in support of RCM services. As an integral part of our RCM team the position serves in a cross-functional, fast-paced environment in order to meet performance and quality assurance benchmarks. Essential duties include all aspects of insurance billing and collections.

Responsibilities:

• Works directly with the insurance company, healthcare provider, and patient to get a claim processed and paid
• Post appropriate adjustments based on client protocols and/or Explanation of Benefits (EOB)
• Keep current on informational changes in billing/collection procedures
• Meet benchmarks for AR volume
• Handling collections on unpaid patient account balances
• Follow client protocols for AR management
• Work with outside collection companies based on client protocols.
• Reviews and appeals unpaid and denied claims
• Know how to read and understand an EOB
• Post appropriate adjustments based on client protocols and/or Explanation of Benefits (EOB).
• Communicate/answer questions regarding outstanding AR issues
• Other duties as assigned

Qualifications

• Excellent communication skills
• Ability to deal with a number of tasks simultaneously
• Strong attention to detail
• Intermediate computer skills
• Understands the importance of maintaining confidentiality; able to maintain confidentiality under HIPAA standards
• Must have the ability to exercise a high degree of diplomacy and tact; excellent customer services skills
• Must be highly flexible; able to accommodate changing needs of the department.
• Must be a self-starter, motivated and have the ability to multi-task
• Training and/or experience with computer data entry
• Knowledge of medical terminology required
• Ability to understand and follow instructions

Physical Elements and Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Regularly required to sit, talk, and hear

Occasionally required to stand and walk

The noise level in is usually moderate