Revenue Cycle Specialist- Work From Home

Description

JOB DESCRIPTION:  

The Revenue Cycle Specialist’s primary responsibility is to submit accurate claims and secure their timely payments. This will be achieved through: accurate client set-up in our billing software; accurate authorization updates in the client set-up, including authorization number and units approved; timely weekly claims generation or claim generation upon discharge (whichever is sooner); collection of deductibles prior to admission; consistent communication of problem claims with the provider representative of each health plan for optimum settlement; accurate processing of EOB’s and timely follow-up on Co-payments with the responsible party;  monthly statement mailings following a 30, 60, 90, collections process; month-end A/R review with billing director and/or CFO to review problem claims and potential bad debt claims; setting up payment plans for CFO approval and insuring adherence to this plans by the client; coordinating with utilization review and discharge planning efforts to limit risk of non-payment.

JOB REQUIREMENTS:

Education: High school graduate or equivalent required.

Experience:  A minimum of one (1) years’ experience in admission processes and collections procedures, and a working knowledge of managed care; interpretation of insurance coverage plans, co-payments and deductible schedules and payment plans; and a working knowledge of computers and business software programs (Excel/Word).  A minimum of one year experience in data entry preferred.  Must be proficient in 10-key and typing.  

Additional Requirements:  Level One Fingerprint Clearance Card and TB Test required within 90 days of employment.

KNOWLEDGE/SKILLS:

  1.   Knowledge of admissions processing/billing processes and procedures.

  2.   Knowledge of insurance coverage, co-payments, and deductibles.

  3.   Knowledge of all revenue code procedures.

  4.   Knowledge of computers and business software, including Excel.

  5.   Knowledge of managed care.

  6.   Knowledge of payment planning and billing techniques.

  7.   Skill in organizing and prioritizing workloads to meet deadlines.

  8.   Skill in telephone etiquette and paging procedures.

  9.   Effective oral and written communication skills.

10.   Ability to communicate effectively with clients and co-workers.

11.   Ability to adhere to safety policies and procedures.

12.   Ability to use good judgement and to maintain confidentiality of information.

13.   Ability to work as a team player.

14.   Ability to demonstrate tact, resourcefulness, patience, and dedication.

15.   Ability to accept direction and adhere to policies and procedures.

16.   Ability to recognize the importance of adapting to the various client groups.

17.   Ability to work in a fast-paced environment.

18.   Ability to meet corporate deadlines.

Qualifications