What are the responsibilities and job description for the Revenue Cycle Management Specialist - Billing position at KPH HEALTHCARE SERVICES, INC?
Job Duties
- Accurately prepare and submit claims for payment from all third-party payers in a timely manner.
- Verify documentation of supplied products align with prepared claim.
- Verify accuracy of billed codes and accuracy of billed and expected amounts.
- Support the resolution of billing issues such as claim resubmissions to all payers, changes in coverage, and claims adjustments.
- Follow up on submitted claims and resolve rejected claims, including claim corrections, update payer ID, update patient insurance record, etc.
- Prepare and submit patient statements.
- Communicate as needed with patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries about billing.
- Support accurate and comprehensive record-keeping to ensure up-to-date information is maintained and effectively shared across departments.
- Assist in the implementation of processes to measure, assess, and improve the performance of the billing department activities of the company.
- Ensure ongoing compliance with all laws and regulations; ensure that the department meets or exceeds accreditation standards; and implement "best practices" in all departmental activities.
- Participate in surveys conducted by authorized inspection agencies.
- Participate in the company's Performance Improvement program as requested by the Performance Improvement Coordinator.
- Participate in company committees when requested.
- Participate in in-service education programs provided by the company.
- Pursue continuing education programs appropriate to job responsibilities.
- Perform other duties as assigned by supervisor.
- Complete all mandatory and regulatory training programs.
- Report any misconduct, suspicious or unethical activities to the Compliance Officer.
- Complies with accepted professional standards and practice.