Medicare: Accounts Resolution Specialist

SUMMARY:

This will be a hybrid remote position once training/onboarding period is successfully completed! Training will be completed on site at our corporate office in Warwick, RI.

Monday- Friday 8:30 AM- 5:00 PM.

Bilingual Spanish preferred.

Under the general supervision of the Billing Manager, this position is responsible for the billing and collection of selected claims for Rhode Island Medical Imaging. This position also assists patients with questions regarding coverage and payment issues. The position is a key component of the cash flow for the institution.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Consistently applies the corporate values of respect, honesty, fairness and constant pursuit of excellence in improving the health status for the people of the region through the provision of customer-friendly, geographically accessible and high-value services within the environment of a diagnostic imaging company.
• Ensures all interactions are in compliance with HIPAA, federal and state compliance regulations.
• Understands all elements associated with completing HCFA 1500 billing forms for the selected payor(s) he/she is responsible for. Understands and resources billing guidelines for each of his/her payor responsibilities and keeps abreast of related changes.
• Recommends modifications to RIMI’s billing system based on knowledge of billing guidelines.
• Is familiar with CPT codes, HCPC codes and ICD-10 codes. Uses department and payor resources to ensure billing is accurate and complete.
• Completes billing and collection duties in a timely and accurate fashion.
• Takes initiative relative to duties, pointing out possible issues or concerns to the Billing Manager and/or COO, PFS.
• Ability to adapt, in a timely manner, to changes in billing/collecting rules as defined by insurance companies and/or Management.
• Ensures all claims are in compliance with the respective carrier rules as well as HIPAA and federal compliance regulations.
• Reviews monthly accounts receivable aging report(s) for assigned payor class and takes action to resolve.
• outstanding accounts and credit balances in a timely fashion.
• Ability to work in a team environment, including cross training and filling in for other team members when directed by the Supervisor and/or Manager.
• Enlists the help of the Billing Manager or Supervisor on an as needed basis to ensure accounts remain collectable.
• Keeps current with all insurance changes regarding policy and coverage guidelines.
• Assists patients with questions regarding their bills in an efficient and professional manner.
• Maintains a professional manner at all times.
• Participates in meetings on an as requested basis.
• Performs other duties as assigned.

BASIC KNOWLEDGE:

Ability to operate modern office machinery; to enter and retrieve information via the PC. Must have knowledge of third-party billing requirements. Excellent telephone and interpersonal skills are essential. Must be able to handle and prioritize workload and work as a team member.

EDUCATION:

High school graduate or equivalent. Post high school courses in insurance billing, computer basics and medical terminology preferred.

EXPERIENCE:

One year of third-party billing experience preferred.

PHYSICAL DEMANDS:

To perform this job successfully an individual must be able to perform each essential duty satisfactorily.  This description is not intended to be a complete statement of the position, but rather to act as a guide to the general work to be performed.  The requirements are representative of the knowledge, skill and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  The individual's competencies and customer requirements impact the actual role performed.  Prolonged periods of repetitive sitting and standing at a desk and working on a computer. Must be able to perform all essential duties without restriction.

Join an award-winning organization! With 16 private, state-of-the-art medical diagnostic imaging facilities, join the team that has been providing Rhode Island with imaging excellence for over 80 years! The American College of Radiology has named RIMI one of the first outpatient diagnostic imaging Centers of Excellence in the country and the first in Rhode Island. 

RIMI offers best-in-class benefits to eligible employees including multi-tiered health plans, flexible spending accounts, generous paid time off, 401(k) plan with profit sharing component, uniform reimbursement, company "swag", yearly reimbursement f