What are the responsibilities and job description for the Biller / Revenue Cycle Management Specialist position at KPH Healthcare Services?
Overview
Job Summary: The Revenue Cycle Management Specialist is to support the process of the company's billing function.
Responsibilities
Job Duties:
- Report any misconduct, suspicious or unethical activities to the Compliance
- Ensure verification of current coverage with third party payers and obtain authorizations as
- Assist in the preparation and submission of claims for payment from third party payers, and invoices for patient co-payments.
- Support the resolution of billing issues such as claim resubmissions to all payers, changes in coverage, and claims
- Communicate as required with patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries about
- Review and approve refunds of third-party payer and patient overpayments.
- Assist in record keeping so that all information is accurate and complete and manage the flow of up-to date information between billing department and other parts of the company, such as the accounts receivable, accounts payable and customer service
- Ensure the implementation of processes to measure, assess, and improve the performance of the billing department activities of the company.
- Review and suggest changes to billing department policies and procedures as needed.
- Ensure ongoing compliance with all laws and regulations; ensure that the department meets or exceeds accreditation standards; and implement "best practices" in all departmental \
- Participate in surveys conducted by authorized inspection
- Participate in the company's Performance Improvement program as requested by the Performance Improvement
- Participate in company committees when
- Participate in in-service education programs provided by the company.
- Pursue continuing education programs appropriate to job
- Perform other duties as assigned by
- Responsible for completing all mandatory and regulatory training programs
- Perform other duties as assigned
Qualifications
Educational Requirements:
- High school diploma or GED
Experience:
- One to three years of experience in Home Nursing/Services or related organization
Credential/Licensure Required:
- Must be a licensed driver with an automobile that is insured in accordance with state and agency requirements and is in good working order
Special Conditions of Employment:
- Drug test
- Initial and continuous exclusion and sanction/disciplinary monitoring
- Any and all additional eligibility requirements based on the specific position
Job Skill Requirements:
- Complies with accepted professional standards and practice
- Has satisfactory references from current employers and professional peers
- Has excellent observation and communication skills
- Is self-directed with the ability to work with little supervision
- Is flexible and cooperative in fulfilling obligations