Job Summary:

An amazing opportunity to join our team as a Revenue Cycle Specialist. The Revenue Cycle Specialist will be responsible for patient account management, communication with payers, follow-up, appeals and customer service. Revenue Cycle Specialist will develop strong knowledge in insurance carrier policies, clearinghouse edits, and clinical requirements to expediate cash flow.

Hours:

M-F: 8AM-4:30PM

Essential Job Functions:

• Responsible for research, initiating follow-up and resolving all account balances
• Follow up on claims not paid, underpaid, and/or denied. Identify root cause denial trends, communicate trends with team, and prepare appropriate appeals as required.
• Maintains compliance with company and government reimbursement policies.
• Issues electronic and paper billing to ensure the appropriate processing by payer, navigates various payer systems to ensure timely resolution of claims.
• Performs the insurance verification functions
• Identifies any patient out-of-pocket responsibility
• Coordinates the pre-authorization, pre-certification and referral processes
• Contacts the patient prior to service for financial arrangements
• Assures that the billing and collection duties assigned are accurately performed and completed 
• Performs billing and collection functions within the Hospital computer system
• Prepares the daily bank deposit
• Researches and resolves customer inquiries, manages correspondence, and posts payments
• Analyzes credit balances, processes refunds and enters procedure charges
• Works with the internal and external customers to maintain accurate records to facilitate billing and collection
• Regular and prompt work-site attendance
• Other duties as assigned

Qualifications, Knowledge & Ability: 

• Medical background working in a healthcare environment required
• Experience working in a hospital preferred
• Knowledge of medical terminology, coding, and claims processing
• Knowledge of medical insurance, Medicare and Medicaid
• Demonstrated exceptional human relations, communication, and coordination skills
• Detail oriented and accurate
• Demonstrates effective decision making skills
• Demonstrates eligibility for employment in the U.S.
• Ability to relate and work effectively with others
• Ability to work accurately and independently with minimal direction

Benefits:

• Comprehensive health, dental, and vision insurance
• Health Savings Account with an employer contribution
• PTO
• 401(k) retirement plan with 4% company match
• Tuition reimbursement
• Wellness reimbursement