REVENUE CYCLE SPECIALIST

This role supports our customers with claims processing, including gathering required documentation and coding information, updating patient accounts with payments, vouchers, and claims / payment status, and communicating with patients and 3rd party insurers about claims and payments.

You will work under moderate supervision with some latitude for independent judgment as you continue to increase your proficiency and apply your skills to the completion of assigned tasks.

The role you play

An effective Revenue Cycle Specialist will help the organization on a whole achieve success through :

• Living our Tegria values : Respect Every Person, Act with Integrity, Strive for Better, Embrace Change, Deliver as a Team
• Preparing and submitting hospital and clinic claims to third-party insurance carriers either electronically or by hard copy billing
• Securing medical documentation required or requested by third party insurances and in accordance with HIPAA regulations.
• Following up with third-party insurance carriers on unpaid claims until claims are paid or only self-pay balance remains
• Processing rejections by either making accounts private and generating a letter of rejection to patient or correcting any billing error and resubmitting claims to third-party insurance carriers.
• Working with physician or medical records staff to ensure that correct diagnosis / procedures are reported to third party insurance carriers
• Making accounts private and notifying patients when claims have not been paid after time frames in established accounts receivable policy
• Keeping updated on all billing and benefit changes for third-party insurance carriers
• Posting third-party insurance remittance vouchers
• Monitoring claims for missing information and authorization / control numbers
• Answering patient telephone calls on the customer service line
• Processing, reviewing, and sending patient statements
• Attending department meetings
• Maintaining and increasing your skills, developing proficiency in the role
• Consulting with more senior team members on work approach and work product
• Performing other duties as assigned

What we’re looking for

We expect :

• High school diploma or GED
• Ability to add, subtract, multiply, divide and calculate percentages.
• One year experience in billing of third-party insurances for healthcare facility and professional services required.
• Knowledge of healthcare third-party billing requirements.
• Able to work successfully with moderate supervision and follow instructions and procedures.
• Able to communicate tactfully and firmly with patients, providers, medical records staff and third-party insurers.
• Must have a private, secure workspace available at home and access to internet with speed sufficient to perform the job

We’d love to see :

Post high school courses in math, bookkeeping business, insurance billing, data processing and / or medical terminology preferred

Success Criteria

• Open to feedback and have a desire to grow their knowledge of revenue cycle claims and billing
• Comfortable and accountable working in a remote work environment video conference calls, share virtual work tools / spaces, etc. are common
• Demonstrate owning their work and seeing it through to the finish
• Not afraid to ask questions or ask for help
• Clear and concise in their written and verbal communication
• Detail-oriented able to catch the small stuff
• Thrive under the pressure of time constraints
• Customer service oriented

Need a few more details?

Targeted Start Date : ASAP

Status : Exempt Regular Full-time

Eligibility : Eligible - Must be legally authorized to work in the US without sponsorship

Compensation : $35,173 - $56,980

Travel : 3 days a week onsite in Hermantown, MN

Benefits Eligibility : Exempt employees are eligible for benefits. W2 hourly consultants are eligible for benefits for contracts that are 2 months and 20 hours per week.

1099 hourly consultants are not eligible for benefits.

Now, a little about us...

At Tegria, we bring bold ideas and breakthroughs to improve care, technology, revenue, and operations in ways that move healthcare organizations from patient-centered to human-centered.

We are helping healthcare put people first both patients and those who dedicate their lives to delivering care.

And at the very core of this vital work is our incredibly talented people.

People with different backgrounds who welcome challenge and change. People who listen first, ask hard questions, and make decisions to cultivate a culture of equity and inclusion.

People who chase after goals greater than their own, and whole-heartedly enjoy laughs, growth, and generosity. We’re real.

We’re nimble, and we believe in our mission to humanize healthcare.

Perks and benefits

Top talent deserves top rewards. We’ve carefully curated a best-in-class benefits package, meant to meet you wherever you are in your life and career.

Your health, holistically. We offer a choice of multiple health and dental plans with nationally recognized networks, as well as vision benefits, a total wellness program, and an employee assistance program for you and your family.

Your financial well-being. We offer competitive wages, retirement savings plans, company-paid disability and life insurance, pre-tax savings opportunities (HSA and / or FSA), and more.

And everything in between.Our lifestyle benefits are unrivaled, including professional development offerings, opportunities for remote work, and our favorite : a generous paid-time-off program, giving you the flexibility to plan a vacation, take time away for illness (or life’s important events), and shift your schedule to accommodate those unexpected curve balls thrown your way.

Tegria is an equal employment opportunity employer and provides equal employment opportunities (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and / or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law.

All qualified candidates are encouraged to apply

Last updated : 2024-04-26