What are the responsibilities and job description for the Revenue Cycle Specialist - Medicare position at Alive Hospice?
Description
Revenue Cycle Specialist (Medicare)Location: Nashville, TN/ RemoteStatus: Full TimeDays: Monday - FridayHours: 40/week
Are you a Revenue Cycle/professional who desires to work in a capacity in which your efforts directly impact clinicians, patients and their families? If you are excited to use your talents and skill set in a way that truly makes a difference in the middle Tennessee healthcare market, we can't wait to talk with you!
Summary
Primarily responsible for generating billing cycles posting payments and follow-up on claims to ensure timely payment.
Essential Duties And Responsibilities
EDUCATION and/or EXPERIENCE
High School diploma required. One year college or technical school: one to three years related experience or equivalent combination of education and experience.
CERTIFICATES, LICENSES, REGISTRATIONS
If required to drive to carry out the duties of this position: current driver's license and automobile insurance as required by Tennessee State Law.
Revenue Cycle Specialist (Medicare)Location: Nashville, TN/ RemoteStatus: Full TimeDays: Monday - FridayHours: 40/week
Are you a Revenue Cycle/professional who desires to work in a capacity in which your efforts directly impact clinicians, patients and their families? If you are excited to use your talents and skill set in a way that truly makes a difference in the middle Tennessee healthcare market, we can't wait to talk with you!
Summary
Primarily responsible for generating billing cycles posting payments and follow-up on claims to ensure timely payment.
Essential Duties And Responsibilities
- Generates patient claims through EMR billing system. Upload EMC file to clearinghouse as soon after target bill date and errors/holds are clear. Continue review of unsubmitted claims to avoid timely filing errors.
- Manage and hold claims waiting compliance review completion. Work with Revenue Cycle team to ensure billing compliance.
- Review, key or follow up on 81A (NOE) prior to submission of initial claim. (if applicable to assigned duties)
- Review, key or follow up on 815's, 817's and 818's when necessary.
- Review and corrects RTP's in the DDE system on a regular basis.
- Post Medicare PIP remittance advices through Clearinghouse auto post or manually when necessary.
- Follows up regularly on unpaid claims by using DDE or phone call to PBGA service center for assistance or unresolved claim issues. Document response and any follow-up actions taken in EMR.
- Work with the Dept. Director on Medicare credit balances to ensure compliance.
- Work with other Hospice agencies to ensure smooth transitions between benefit periods and sequential billing.
- Notifies the Dept. Director of any problems with claims or processes.
- Assists other Revenue Cycle Specialist as needed to meet department goals.
- Submit write off requests with documentation after all collection efforts have been exhausted to the Dept. Director.
- Run admission report, assign and enter appropriate ICD-10 codes into EMR based on physician CTI. (if applicable to assigned duties)
- Using pre-bill CPT audit sample to complete compliance review through physician coding compliance software. Report findings to appropriate Directors and CMO. (if applicable to assigned duties)
- Report individual finds to the physician for review and resolution of the coding discrepancy. After physician review/approval make coding changes and note in EMR. Report to billing staff when claim can be released. (if applicable to assigned duties)
- Other duties may also be assigned.
EDUCATION and/or EXPERIENCE
High School diploma required. One year college or technical school: one to three years related experience or equivalent combination of education and experience.
CERTIFICATES, LICENSES, REGISTRATIONS
If required to drive to carry out the duties of this position: current driver's license and automobile insurance as required by Tennessee State Law.