Revenue Cycle Management Specialist - Group

As a Revenue Cycle Management Specialist, you will play a crucial role in the Revenue Cycle Management (RCM) process, ensuring the timely and accurate processing of accounts receivable transactions. This position requires a detail-oriented and proactive individual who can navigate the complexities of healthcare billing and collections. You will play a pivotal role in contributing to the financial health of our clients by optimizing revenue streams and maintaining positive relationships with healthcare providers.

You will serve as a resource for problem solving issues and developing account action plans.

• Build strong partnerships with Hyderabad transactional teams to support account performance excellence.
• Create and submit claims for medical services rendered to insurance companies and patients.
• Obtain supporting documentation, such as medical records, EOBs, Remits, Authorizations, referrals, etc., through email applications, scanning systems, Medicare remittance systems, etc.
• Review denied physician billing medical claims to ensure coding was appropriate and make corrections as needed, contact insurance companies to resolve and recover denied claims.
• Monitor aging reports for timely follow‑up on unpaid claims.
• Perform retroactive review of registration data to aid in the assurance of clean claim submittal.
  
  Accurately document claim actions taken within patient account/claims, including resolutions.
• Serve as a resource for problem solving issues related to registration, demographic, and insurance errors.
• Work collaboratively with cross functional teams, Managers, and practice staff to resolve claim and account issues.
• Initiative and communicate the resolution of client issues and monthly KPI trending.
• Adhere to HIPAA guidelines regarding confidentiality relating to the release of financial and medical information.
• Ensure billing and coding are correct prior to sending appeals or reconsiderations to payers.
• Review and identify trends or patterns of denials to prevent errors and improve conversion.
• Assist and coordinate with coder and billing manager concerning claim coding problems.
• Stay current with compliance and changing regulatory guidelines.
• Demonstrate knowledge of coding and medical terminology to effectively know if claim denied appropriately and if appeal is warranted.
• Support and participate in process and quality improvement initiatives.
• Achieve goals set forth by supervisor regarding error‑free work, transactions, processes, and compliance requirements.
• Exhibit exceptional customer service skills, answering patient and insurance calls, prompt return and follow‑up to all interactions, prompt response to requests for information, both internally and externally.
• Deliver timely required reports to the management team, initiate, and communicate the resolution of issues, such as payor denial trends due to coding and billing errors.
• Identify missing payments, over payments, and analyze account credits.
• Work with collaborative group to facilitate information and resolve charge questions.
• Maintain accurate records of actions taken on behalf of clients to obtain reimbursement for medical services provided.
• Aid in reconciling deposit logs with posting reports to guarantee the integrity and precision of every transaction.
• Follow Unis Link’s vision and mission with regards to exceeding customer expectations.
• Promote Unis Link’s core values of Respect, Integrity, Customer Focus, and Continuous Improvement
• Ensure confidentiality of sensitive information and that all communications are handled consistent with compliance policies. Actively comply with all Unis Link policies and procedures.
• Other duties as assigned.

• Minimum of 3-5 years’ experience in a Physician Billing…