Revenue Cycle Specialist
GENERAL PURPOSE:
The Revenue Cycle Specialist is responsible for billing, collections, and revenue cycle management functions.
ESSENTIAL FUNCTIONS:
• Prepares and submits insurance claims to appropriate payers
• Ensures claims are received by payer timely correcting, rebilling, or appealing as necessary.
• Follows up with payers to confirm accurate payment. Contacts payers claims departments to address and correct billing errors and omissions
• Generates necessary reports including billing and collections.
• Answer patient questions and advise them on insurance coverage and benefits
• Establish repayment plans and arrangements with delinquent patients
• Stays current with any payer related changes; may be provider specific or regulatory revisions.
• Actively contribute to special projects and offers feedback to improve processes.
• Analysis AR recognizing potential delays and trends with payers such as corrective actions and responds to avoid A/R aging.
• Escalates payment delays/problem aged account timely to Supervisor.
• Additional duties as assigned by Supervisor.
QUALIFICATIONS:
• High School Education or GED
• Medical billing and collections background preferred
• Experience in Home Health, Hospice or Long-term care preferred
• Knowledge of electronic billing via EMR and medical billing software
• Understanding of the requirements of Medicaid, Medicare and Insurance billing is preferred
• Accounts Receivable skills and medical terminology is a plus
• Computer proficiency – MS Office and web enabled applications strongly preferred
• Excel knowledge
ADDITIONAL REQUIREMENTS:
• Willingness to learn
• Self-motivation and the ability to work independently as well as in a team
• Provide quality customer services to internal and external teams
• Must be able to work productively in an environment with high levels of interruption; work efficiently and effectively meeting multiple deadlines and changing priorities with strong attention to detail
• Exceptional organization skills
• Ability to maintain confidentiality
• Ability to effectively communicate with all levels of management
• Strong work ethic: results focus with a strong desire to achieve goals
• Ability to use a computer keyboard and mouse 6-8 hours a day
• Occasionally lift/carry items weighing up to 25 lbs.
• Ability to dial, answer and talk on a telephone for multiple hours a day
• Ability to handle completing a task in high levels of interruption while paying close attention to detail