Revenue Cycle Specialist- Work From Home

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Job Description

The Revenue Cycle Specialist’s primary responsibility is to submit accurate claims and secure their timely payments. This will be achieved through: accurate client set-up in our billing software; accurate authorization updates in the client set-up, including authorization number and units approved; timely weekly claims generation or claim generation upon discharge (whichever is sooner); collection of deductibles prior to admission; consistent communication of problem claims with the provider representative of each health plan for optimum settlement;

accurate processing of EOB’s and timely follow-up on Co-payments with the responsible party; monthly statement mailings following a 30, 60, 90, collections process; month-end A/R review with billing director and/or CFO to review problem claims and potential bad debt claims; setting up payment plans for CFO approval and insuring adherence to this plans by the client; coordinating with utilization review and discharge planning efforts to limit risk of non-payment.

Job Description

The Revenue Cycle Specialist’s primary responsibility is to submit accurate claims and secure their timely payments. This will be achieved through: accurate client set-up in our billing software; accurate authorization updates in the client set-up, including authorization number and units approved; timely weekly claims generation or claim generation upon discharge (whichever is sooner); collection of deductibles prior to admission; consistent communication of problem claims with the provider representative of each health plan for optimum settlement;

accurate processing of EOB’s and timely follow-up on Co-payments with the responsible party; monthly statement mailings following a 30, 60, 90, collections process; month-end A/R review with billing director and/or CFO to review problem claims and potential bad debt claims; setting up payment plans for CFO approval and insuring adherence to this plans by the client; coordinating with utilization review and discharge planning efforts to limit risk of non-payment.



Job Requirements

Education:
High school graduate or equivalent required.

Experience: A minimum of one (1) years’ experience in admission processes and collections procedures, and a working knowledge of managed care; interpretation of insurance coverage plans, co-payments and deductible schedules and payment plans; and a working knowledge of computers and business software programs (Excel/Word). A minimum of one year experience in data entry preferred. Must be proficient in 10-key and typing.

Additional Requirements: Level One Fingerprint Clearance Card and TB Test required within 90 days of employment.

Knowledge/Skills

• Knowledge of admissions processing/billing processes and procedures.
• Knowledge of insurance coverage, co-payments, and deductibles.
• Knowledge of all revenue code procedures.
• Knowledge of computers and business software, including Excel.
• Knowledge of managed care.
• Knowledge of payment planning and billing techniques.
• Skill in organizing and prioritizing workloads to meet deadlines.
• Skill in telephone etiquette and paging procedures.
• Effective oral and written communication skills.
• Ability to communicate effectively with clients and co-workers.
• Ability to adhere to safety policies and procedures.
• Ability to use good judgement and to maintain confidentiality of information.
• Ability to work as a team player.
• Ability to demonstrate tact, resourcefulness, patience, and dedication.
• Ability to accept direction and adhere to policies and procedures.
• Ability to recognize the importance of adapting to the various client groups.
• Ability to work in a fast-paced environment.
• Ability to meet corporate deadlines.

• Seniority level
  
  Entry level

• Employment type
  
  Other

• Job function
  
  Accounting/Auditing and Finance
• Industries Hospitals and Health Care

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