Biller​/Revenue Cycle Management Specialist

Overview

The Revenue Cycle Management Specialist is to support the process of the company's billing function.

• Report any misconduct, suspicious or unethical activities to the Compliance
• Ensure verification of current coverage with third party payers and obtain authorizations as required
• Assist in preparation and submission of claims for payment from third party payers, and invoices for patient co‑payments
• Support the resolution of billing issues such as claim resubmissions to all payers, changes in coverage, and claims
• Communicate as required with patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries
• Review and approve refunds of third‑party payer and patient over payments
• Assist in record keeping so that all information is accurate and complete and manage the flow of up‑to‑date information between billing department and other parts of the company, such as accounts receivable, accounts payable and customer service
• Ensure the implementation of processes to measure, assess, and improve the performance of the billing department activities of the company
• Review and suggest changes to billing department policies and procedures as needed
• Ensure ongoing compliance with all laws and regulations; ensure that the department meets or exceeds accreditation standards; and implement "best practices" in all departmental processes
• Participate in surveys conducted by authorized inspection
• Participate in the company's Performance Improvement program as requested by the Performance Improvement
• Participate in company committees when requested
• Participate in in‑service education programs provided by the company
• Pursue continuing education programs appropriate to job
• Perform other duties as assigned
• Responsible for completing all mandatory and regulatory training programs

• High school diploma or GED

• One to three years of experience in Home Nursing/Services or related organization

• Must be a licensed driver with an automobile that is insured in accordance with state and agency requirements and is in good working order

• Drug test
• Initial and continuous exclusion and sanction/disciplinary monitoring
• Any and all additional eligibility requirements based on the specific position

• Complies with accepted professional standards and practice
• Has satisfactory references from current employers and professional peers
• Has excellent observation and communication skills
• Is self‑directed with the ability to work with little supervision
• Is flexible and cooperative in fulfilling obligations