Revenue Cycle Specialist II, RCM

The Revenue Cycle Specialist II is a position that calculates and posts receipts to appropriate accounts, verifies details of transactions; performs billing, posting and collection of claims related to specific payers. In this role, you will report to the Accounts Receivable Manager, RCM.

Duties/Responsibilities:

• Monitor held billing and coordinate resolution of related issues to ensure timely claim submission

• Review, research, and correct claims that fail payer edits; update payer information and resubmit claims within the EMR system as needed

• Understand and actively follow up on outstanding accounts receivable to minimize aging

• Work all assigned and denied claims promptly and accurately

• Assist in preparing and submitting appeals and reconsiderations to payers

• Collaborate with internal teams (billing, authorizations, clinical, etc.) to resolve billing and collections issues

• Communicate with payers to obtain claim status and resolve outstanding balances

• Maintain accurate documentation of collection activities and provide updates and reports on collection efforts as requested

• Assist with special projects, audits, or process improvement initiatives as assigned

• Identifies trends related to denials/coding and delinquent claims and communicate effectively with client manager for feedback to the client

• Identifies system/payer issues such as rates, codes, set up and coordinate accordingly

• Reports status of accounts and issues to appropriate supervisors and departments – always maintains full transparency of accounts

• Follows requirements through the full cycle until accounts are satisfied, including patient collections and appeals

• Documents, processes and coordinates all write offs and adjustments as needed

• Works with contracting team and management to resolve payer issues

• Works with branches for all questions on accounts

• Attends regular meetings with teams and management to ensure open communication

• Perform other duties as assigned

Required Skills/Abilities/Knowledge:

• Excellent verbal, written and computer communication skills

• Able to communicate across all levels of authority within company

• Excellent organization, problem solving, and project/time management skills

• Able to work with multiple teams within the organization to promote viable, ethical, and cost-effective solutions

• Proven track record of successful collections

• Able to effectively deal with change

• Able to complete projects within specific timetables

• Able to successfully interact with people in face-to-face situations as well as by telephone in a professional and effective manner

• Satisfactory background screens as required by State, Federal and Company policy free of any OIG sanctions

Education/Experience/Licenses/Certifications:

• Graduate of accredited high school or GED required

• Minimum of two years of experience in health-related accounts receivable and collections

Physical Requirements:

“You are not required to disclose information about physical or mental limitations that you believe will not interfere with your ability to do the job.  However, you should disclose any physical or mental impairment for which special arrangements or accommodations are needed to enable you to perform the essential functions of the job. Your description of any impairment and suggestions for reasonable accommodations will be considered in providing reasonable accommodations.”

• Requires the ability to write, dictate or use a keyboard to communicate directives

• Utilizes proper body mechanics in multiple environments

• Requires the ability to function in multiple environments

FLSA Status:  Non-Exempt

EEO Status:  Administrative Support Workers
 

Benefits + Perks of Joining the Team Select Family

• Medical, Dental, and Vision Insurance

• Paid Time Off and Paid Sick Time

• 401(k)

• Referral Program

Pay Range: $19.00 - $24.00 / hour

 

Team Select Home Care reserves the right to change the above job description and qualifications without notice. Team Select Home Care will not discriminate against you on the basis of race, color, religion, national origin, sex, sexual preference, disability, political belief, veteran status