Revenue Cycle Specialist
13 days ago
New Paltz
Job Description Family Health Service Provider with a statewide presence is seeking to add some Revenue Cycle Specialists to the team in their New Paltz location. Starting salary varies by experience plus great benefits. Join a collaborative team that emphasizes a "second family" atmosphere and room for career growth. Hybrid schedule after first 90 days (3 days per week in office) Description 1) The Revenue Cycle Specialist II This position requires advanced working knowledge of medical accounts receivable billing and collections. Must demonstrate the ability to complete work in designated area of accounts receivable with measurable results. Staff in this position is required to meet standards and goals within their designated area of accounts receivable. Designated areas of responsibility include but are not limited to the following: 1. Self-pay/Sliding Fee2. Managed Care Plans, 2. Medicaid, 3. Medicare, 4. Commercial Plans, 5. Payment/denial posting Requirements Ability to perform clerical/technical/service/administrative tasks. Ability to identify, analyze, and research denial patterns. Maintains complete understanding of assigned area of accounts receivable. Able to identify and resolve credit balances. Assures collections of designated accounts receivable are accomplished through proper follow-up and adherence to existing policies and procedures for that area. Reviews all correspondence on a daily basis for denials and short paid claims. Reviews and processes all Explanation of Benefits for designated accounts. May be tasked to post payments and denials for designated accounts upon receipt. Performs work queue activities according to designated account receivable area’s policies and procedures. This is a method whereby designated accounts will be worked on a daily basis. A minimum number of accounts worked to be determined by management. Performs corrections as required based on information found on Error Reports, various work queues or other methods as assigned. This includes both internal and external errors and is to be reviewed and corrected on a daily or weekly basis. Communicates to management information related to changes required for designated area to facilitate the collection of accounts receivable. Works Aged Accounts Receivable on a daily/weekly basis to ensure that designated accounts are processed timely and work queues are kept current according to the standards set by the department. This will be done via various work queues and reports. Verifies and performs data entry of patients’ personal/insurance information as needed to assist in payment of debt for designated accounts. Responds to incoming telephone, mail and email inquiries from patients, providers and payers regarding outstanding balance. Interacts with other departments, insurance companies, medical professionals and patients’ on daily basis. Recognizes issues relating to provider credentialing and payer contracts and communicates such information in a timely manner to their manager for escalation. Maintains familiarity with the Institute fee schedules as well as CPT and ICD-10 coding and keeps up to date on annual changes. Maintains patient/employee confidentiality in the management of protected information. May be responsible for Claim Printing/Reviewing of printed claim forms for accuracy to ensure claims are paid timely. May be responsible for the submission of electronic claim and/or patient statement files depending on designated accounts receivable. May post charges as assigned for sites without automatic entry of electronic encounters. May be asked to participate in new staff orientation programs to familiarize them with coding and billing procedures and policy updates as deemed necessary. May be asked to assist with special projects. Participates in the department’s performance improvement activities. Maintains patient/employee confidentiality in the management of information. Observes the Health Care System’s compliance policies. Participates in the development of other staff members as needed. SKILLS: Experience with collections, commercial insurance, billing, medical terminology, CPT, ICD-10. Typing/keyboarding and data entry skills. Experience creating and maintaining Excel spreadsheets. Strong customer service skills. Effective in taking action with being told (self-motivated, take initiative). Ability to maintain cooperative, friendly and mutually supportive work environment: a “team” player. Ability to maintain congenial, professional, courteous, and respectful attitude in dealing with co-workers, payers, patients, and outside community. Excellent verbal and written communication skills. Ability to deal calmly with individuals under stress. QUALITIFICATIONS: HS Diploma or GED required. Associate's degree in business, Accounting, or Healthcare preferred. Medical Billing & Coding or Medical Administrative Assistant Certification. 2+ years of medical billing and/or collections experience or one (1) full year IFH experience as a Revenue Cycle Specialist I required. Knowledge of CPT and ICD-10 Coding required. Description 2) Revenue Cycle Specialist I Ideal candidates are cognizant of the philosophy, standards, objectives and policies of the Department and the Organization. The representative shall have a basic understanding of medical billing and collections and will provide support to senior representatives to facilitate the collections of accounts receivable. Staff in this position must be able to complete basic tasks within the department which requires the ability to perform administrative, data entry, and /or customer service duties. Requirements Maintains complete understanding of designated accounts. Assures the smooth operation of designated accounts receivable through proper follow-up and adherence to existing policies and procedures for the assigned area. Reviews and processes correspondence on a daily basis. Reviews and processes Explanation of Benefits for designated accounts and posts payments and denials accurately upon receipt. Provides clerical support to senior representatives such as mailing paper claims, preparing spreadsheets for appeals, or maintaining data spreadsheets as directed by the manager (s). Communicates to management information related to changes required for designated areas to facilitate the collection of accounts receivable. May be responsible for specific Aged Accounts Receivable’s on a weekly basis to ensure that designated accounts are processed timely. This will be done via various work queues and reports. Verifies eligibility and performs data entry of patients’ personal/insurance information as needed to assist in payment of debt for designated accounts. Responds to incoming telephone, mail and email and Epic CRM inquiries from patients, providers and payers regarding outstanding balance. Interacts with other departments, insurance companies, medical professionals and patients on daily basis. Recognizes issues relating to claims denials and communicates such information in a timely manner to the manager of the billing department. Maintains familiarity with the Institute fee schedules as well as CPT and ICD-10 coding; keeps up to date on annual changes. May be responsible for Claim Printing/Reviewing of printed claim forms for accuracy to ensure claims are paid timely. Maintains patient/employee confidentiality in the management of protected information. May be responsible for the submission of electronic claim and/or patient statement files depending on designated accounts receivable. May post charges or payments as assigned without automatic electronic assistance. Facilitate the collections of patient due balances through applicable collections processes. May be asked to participate in new staff orientation to familiarize them with procedures and policy updates as deemed necessary. May be asked to assist with special projects. Participates in the department’s performance improvement activities. Maintains patient/employee confidentiality in the management of information. Observes the Health Care System’s compliance policies. QUALIFICATIONS: High School Diploma or GED required. Associate's degree in business, accounting or healthcare preferred. Medical Billing & Coding or Medical Administrative Assistant Certifications preferred. Minimum of 3-6 months related office experience in a business office. Company DescriptionExcellent opportunity.Excellent opportunity.