What are the responsibilities and job description for the Revenue Cycle Specialist II position at Proforma Health?
Role Overview
The Revenue Cycle Specialist II (Physician Billing) is responsible for providing expert support in Commercial and Government billing, collections, and accounts receivable.
Key Responsibilities
The Revenue Cycle Specialist II (Physician Billing) is responsible for providing expert support in Commercial and Government billing, collections, and accounts receivable.
Key Responsibilities
- Reviewing and submitting multi-specialty claims to third-party payors.
- Performing account follow-up and updating patient registration information.
- Researching, analyzing, and resolving complex billing cases and problem accounts with minimal supervision.
- Serving as a technical resource and acting as back-up in other revenue cycle functions.
- Billing, submitting appeals, and collecting reimbursements for physician services.
- Monitoring and processing accounts, ensuring accuracy and resolution.
- High school diploma or GED required.
- Minimum of three years’ experience in physician billing and collections, including CMS1500 experience preferred.
- Expert knowledge of medical terminology, coding (ICD, CPT, HCPCS), and payor procedures.
- Experience with insurance procedures, Explanation of Benefits (EOB), and billing systems like MS Office, Web/Vs, Availity, and CS-Link.
- Strong understanding of regulatory policies, HIPAA, and privacy guidelines.
- Ability to interpret insurance regulations, prioritize tasks, and handle high-volume environments.
- Professional, courteous demeanor and effective communication skills.