Description

Position Overview:

The RCM Clerk works in an office setting during regular business hours. The role may involve working under pressure to meet tight deadlines, managing conflicting priorities, and adapting to changes in project requirements. This position will provide support to our billing team as they work with the insurance company, healthcare provider, and patient to get invoices processed and paid. This position will work closely with leadership on projects related to RCM. The position is primarily responsible for supporting the Revenue Cycle Management team with administrative tasks to expedite the turnaround of claim submissions and processing of paper documentation.

Job Responsibilities

· Performs system maintenance for all electronic remittance advice and electronic funds transfer setup with all contracted insurance carriers.

· Responds to emails in the RCM shared Inbox.

· Maintain files and control records to show correspondence activities.

· Read incoming correspondence to ascertain nature of writers' concerns and to determine disposition of correspondence.

· Gather records pertinent to specific problems, review them for completeness and accuracy, and attach records to correspondence as necessary.

· Ensure that money enclosed in correspondence is correctly documented and directed to accurate department.

· Retrieves medical records from hospital(s) and/or practice group(s) and attaches information to the appropriate documents as needed.

· Retrieves explanation of benefits from software and attaches to the appropriate documents such as claim forms.

· Retrieves supporting documentation from software and prepares for mailing.

· Prints, folds, stuffs and prepares documents for mailing.

· Assists with patient call center for patient related billing inquiries.

· Following up with the needed team members to get all payments posted prior to month end.

· Resolve any unapplied payments and unposted deposits. 

· Coordinates estimated patient financial responsibility obligations/Hardship Program and assures appropriate prepayments are made prior to those services being rendered where appropriate.

· Creates and maintains all revenue cycle operations policies and procedures as well as standard operating procedures.

· Coordinates all aspects of the refund workflow process for all credit balances as well as insurance refund requests/takebacks.

· Works in office

Requirements

Minimum Qualifications:

· High School Diploma or GED (Required)

· 1 year relevant work experience

· Ability to effectively use payer websites and web-based applications

· Ability to perform several tasks concurrently with ease and professionalism.

· Ability to work independently and without constant supervision

· Strong attention to detail

· Ability to communicate clearly and concisely, verbally and in writing

· Must be able to keep client matters strictly confidential.

Physical Demands and Working Environment

The conditions herein are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.

Environment: Standard office setting; tasks are regularly performed without exposure to adverse environmental conditions; frequent interaction with staff and the general public. The role requires that you wear a headset, access and work within multiple systems while addressing callers’ concerns in real time.

Physical: Incumbents require sufficient mobility to work in an office setting; stand or sit for prolonged periods of time; operate office equipment including use of a computer keyboard; light lifting, carrying, pushing and pulling; ability to verbally communicate to exchange information.

Vision: See in the normal visual range with or without correction; vision sufficient to read computer screens and printed documents; and to operate assigned equipment.

Hearing: Hear in the normal audio range with or without correction.