AR Revenue Cycle Specialst II
2 months ago
We are seeking a AR Revenue Cycle Specialist II responsible for the collection of unpaid third-party claims and resolution of non-standard appeals, using various JHM applications and JHU/ PBS billing applications. Will conduct on-line research to locate information to resolve issues across different sub-specialties and/or relating to high-cost procedures. Communicates with payers to resolve issues and facilitate prompt payment of claims. Follow-up with insurance companies to collect outstanding accounts for which payment has not been received in response to the claims submission process, either electronically or by paper. The Specialist will use a comprehensive knowledge of claims submission requirements for all payors in order to expedite payments. The Specialist will research and interpret medical policies regarding denials based on medical necessity. Will use a working knowledge of local coverage determinations (LCD's) to research and apply appropriately. Will mentor and advise junior specialists as appropriate.
Specific Duties & Responsibilities
- Uses A/R follow-up systems and reports to identify unpaid claims for collection/appeal.
- Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract.
- Review and update patient registration information (demographic and insurance) as needed.
- Resolves claim edits
- Drafts and resolves non-standard appeals.
- Researches medical policies to resolve denials based on medical necessity
- Researches and applies LCD's
- Resolves issues across different sub-specialties and/or related to specialized, complex or high cost procedures.
- Applies appropriate discounts / courtesies based on department policy.
- Prepares delinquent accounts for transfer to self-pay collection unit according to the follow-up matrix.
- Prints and mails claim forms and statements according to the follow-up matrix.
- Retrieves supporting documents (medical reports, authorizations, etc) as needed and submits to third-party payers.
- Appeals rejected claims and claims with low reimbursement.
- Confirm credit balances and gathers necessary documentation for processing refund.
- Identifies insurance issues of primary vs. secondary insurance, coordination of benefits eligibility and any other issue causing non-payment of claims.
- Contacts the payors or patient as appropriate for corrective action to resolve the issue and receive payment of claims.
- Monitor invoice activity until problem is resolved.
- Advises junior specialists as appropriate, confirms and assumes responsibility for escalated issues.
- Identifies and informs the supervisor / Production Unit Manager of issues or problems associated with non-payment of claims and non-standard appeals.
Professional & Personal Development
- Participate in on-going educational activities.
- Keep current of industry changes by reading assigned material on work related topics.
- Complete three days of training annually.
Service Excellence
- Must adhere to Service Excellence Standards.
- Customer Relations
- Self-Management
- Teamwork
- Communications
- Ownership/Accountability
- Continuous Performance Improvement
Knowledge, Skills & Abilities
- Ability to use various billing and patient information computer systems.
- Knowledge of various payer processing and submission guidelines.
- Able to maintain consistent above average productivity due to comprehensive knowledge, and ability to make data based and timely decisions.
- Comprehensive knowledge of and compliance to HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI).
- Comprehensive knowledge of medical billing applications.
- Utilize online resources to research policy and regulations to facilitate efficient claims processing.
- Ability to resolve issues across different sub-specialties, and/or specialized/complex high value procedures.
- Excellent interpersonal, communication and customer service skills required.
- Knowledge of medical terminology, CPT codes and diagnosis coding.
- Demonstrated experience resolving third-party payor insurance processing issues, including appeals and denials.
- Ability to perform on-line research and analyze data for conclusive thought.
Physical requirements for the job
- Able to sit in a seated position for extended periods of time.
- Able to reach by extending hand(s) or arm(s) in any direction.
- Finger dexterity required, able to manipulate objects with fingers rather than entire hand(s) or arm(s), e.g., use of computer keyboard.
Minimum Qualifications
- High School Diploma or graduation equivalent.
- Two years experience in a medical billing, insurance follow-up processing, or similar medical specialty environment.
Classified Title: AR Revenue Cycle Specialist II
Role/Level/Range: ATO 40/E/02/OD
Starting Salary Range: $16.00 - $28.50 HRLY ($46,280 targeted; Commensurate with experience)
Employee group: Full Time
Schedule: M-F; 40hrs
Exempt Status: Non-Exempt
Location: Hybrid/JH at Middle River
Department name: SOM DOM Billing
Personnel area: School of Medicine
-
Director of Revenue Cycle Management
2 weeks ago
Baltimore, Maryland, United States Larry White Associates Full timeDirector of Revenue Cycle ManagementThis is a key leadership position for a medical billing company serving a large healthcare system. The Director of Revenue Cycle Management will oversee the revenue cycle management for the client's Durable Medical Equipment/Home Infusions (HME) sector. The ideal candidate will have experience with DME/HME billing and a...
-
Revenue Cycle Accounts Receivable Specialist
2 weeks ago
Baltimore, Maryland, United States University Of Maryland Oral Full timeJob SummaryWe are seeking a highly motivated and organized Revenue Cycle Accounts Receivable Specialist to join our team at the University of Maryland Oral. As a key member of our revenue cycle team, you will be responsible for reviewing and resolving patient accounts, ensuring timely payment, and maintaining accurate records.Key ResponsibilitiesReview and...
-
Revenue Cycle Specialist
2 months ago
Baltimore, United States Health Care for the Homeless Full time $47,388 - $59,235Revenue Cycle Specialist (Hybrid)Full Time Non-Exempt421 Fallsway, Baltimore, MD, USRequisition ID: 1752Salary Range:$47,388.00 To 59,235.00 AnnuallyOverview: Revenue cycle specialist is an account receivables and billing expert who will perform necessary tasks for revenue cycle management including but not limited to claims management, A/R and denials...
-
Revenue Cycle Accounts Receivable Specialist
1 month ago
Baltimore, Maryland, United States University Of Maryland Oral Full timeJob SummaryWe are seeking a highly motivated and detail-oriented Revenue Cycle Accounts Receivable Specialist to join our team at the University of Maryland Oral. As a key member of our revenue cycle team, you will be responsible for reviewing and resolving aged patient accounts, ensuring timely payment, and maintaining accurate records.Key...
-
Revenue Accounting Manager
4 weeks ago
Baltimore, United States NATIONAL CENTER ON INSTITUTIONS AND Full timeJob DetailsJob Location National Center on Institutions and Alternatives Inc - Baltimore, MD Position Type Full Time Education Level Bachelor's Degree Travel Percentage None Job Shift Day Job Category Accounting DescriptionJob Title:Director of Revenue/Client Accounting Department:Fiscal Reports To:Vice President, Finance and Administration FLSA Status:...
-
Financial Specialist
15 hours ago
Baltimore, Maryland, United States LifeBridge Health Full timeFinancial Specialist - International Revenue GrowthReporting to the Manager, Revenue Cycle at LifeBridge Health, this role contributes to growing national and international clinical care services within the organization. Key responsibilities include assisting in revenue growth initiatives and coordinating self-pay patient accounts.Key Responsibilities:Assist...
-
Patient Accounts Specialist II
1 month ago
Baltimore, Maryland, United States Mt. Washington Pediatric Hospital Full timeJob SummaryThe Patient Accounts Specialist II plays a critical role in the revenue cycle process, ensuring timely and accurate billing and follow-up on third-party and patient accounts. This position requires strong analytical skills, attention to detail, and excellent communication skills to effectively interact with hospital staff, insurance companies, and...
-
Baltimore, Maryland, United States University of Maryland Medical System Full timeJob SummaryWe are seeking a highly skilled Facility Admissions Coordinator II, Clinical Dental to join our team at the University of Maryland Medical System. This role will be responsible for performing scheduling, registration, pre-admission processing, wayfinding, and other administrative duties, while adhering to department-specific standards for data...
-
Medical Billing Specialist
1 week ago
Baltimore, Maryland, United States Quadrant Full timeMedical Billing SpecialistJob Summary:We are seeking a skilled Medical Billing Specialist to join our team at Quadrant. The successful candidate will be responsible for managing the revenue cycle, ensuring accurate and timely billing, and maintaining compliance with government regulations.Key Responsibilities:• Serves as a lead worker and trainer for...
-
Director of Billing
3 months ago
Baltimore, United States Robert Half Full timeRobert Half has a new direct-hire opportunity for a Billing Director (Revenue Cycle) for a growing healthcare company in Baltimore, MD. This position offers a hybrid work schedule and ability to work with a tenured leadership team.Job Summary: The Billing Director is responsible for overseeing all aspects of the hospital's revenue cycle and billing...
-
Director of Billing
2 weeks ago
Baltimore, United States Robert Half Full timeRobert Half has a new direct-hire opportunity for a Billing Director (Revenue Cycle) for a growing healthcare company in Baltimore, MD. This position offers a hybrid work schedule and ability to work with a tenured leadership team.Job Summary: The Billing Director is responsible for overseeing all aspects of the hospital's revenue cycle and billing...
-
Director of Billing
2 weeks ago
baltimore, United States Robert Half Full timeRobert Half has a new direct-hire opportunity for a Billing Director (Revenue Cycle) for a growing healthcare company in Baltimore, MD. This position offers a hybrid work schedule and ability to work with a tenured leadership team.Job Summary: The Billing Director is responsible for overseeing all aspects of the hospital's revenue cycle and billing...
-
Director of Billing
2 weeks ago
baltimore, United States Robert Half Full timeRobert Half has a new direct-hire opportunity for a Billing Director (Revenue Cycle) for a growing healthcare company in Baltimore, MD. This position offers a hybrid work schedule and ability to work with a tenured leadership team.Job Summary: The Billing Director is responsible for overseeing all aspects of the hospital's revenue cycle and billing...
-
Baltimore, Maryland, United States Werfen Full timeJob Title: Field Service Engineer IIWerfen is a leading company in specialized diagnostics, and we are seeking a highly skilled Field Service Engineer II to join our team.This role involves building and maintaining relationships with customers to retain the North American customer install base while performing thorough installations, repairs, preventative...
-
Baltimore, Maryland, United States University of Maryland Medical System Full timeJob SummaryWe are seeking a highly skilled Facility Admissions Coordinator II Clinical Dental to join our team at the University of Maryland Medical System. This role is responsible for performing scheduling, registration, pre-admission processing, wayfinding, and other administrative duties, while adhering to department-specific standards for data entry and...
-
Accountant Advanced
2 weeks ago
Baltimore, Maryland, United States State of Maryland Full timeJob SummaryWe are seeking a highly skilled Accountant Advanced to join our team at the State of Maryland. The successful candidate will provide accounting, revenue, and budget support to the Division of Budget, Accounting and Revenue (BAR) of the Office of Finance-Medicaid.Key ResponsibilitiesProvide accounting, revenue, and budget support to the Division of...
-
Accountant Advanced
2 weeks ago
Baltimore, Maryland, United States State of Maryland Full timeJob SummaryThis position reports to an Accountant Supervisor II and provides Accounting, Revenue and Budget support to the Division of Budget, Accounting and Revenue (BAR) of the Office of Finance-Medicaid.The duties of this position include federal, special and reimbursable revenue collections, reporting and reconciliation; federal fund claiming of...
-
Payer Relations Specialist
2 weeks ago
Baltimore, Maryland, United States University of Maryland Medical System Full timeJob SummaryUniversity of Maryland Medical System is seeking a skilled Payer Relations Specialist to provide support to Payer operations with UMMS contracted commercial, Medicare Advantage, and Medicaid MCO Payers.Key ResponsibilitiesMaintain amicable and professional relations with Payer Representatives.Monitor payer policy updates and assess their...
-
Account Executive
4 weeks ago
Baltimore, Maryland, United States Bridgeway Benefit Technologies Full timeAccount Executive Job DescriptionBridgeway Benefit Technologies is seeking a seasoned Account Executive to drive revenue growth and develop strategic business relationships in the multi-employer market.Key Responsibilities:Develop and implement sales strategies to increase revenue and expand the company's presence in the industry.Identify, qualify,...
-
Epic Application Coordinator Senior Level
4 weeks ago
Baltimore, Maryland, United States Johns Hopkins HealthCare Full timeJob SummaryThe Application Coordinator (AC) plays a crucial role in the development and design of Epic applications, requiring in-depth knowledge of assigned modules. This position involves collaborating with Revenue Cycle operational leadership to devise and implement innovative solutions, maintaining existing infrastructure, and interacting with diverse...