Revenue Cycle Specialist
1 month ago
In this role you will:
The Revenue Cycle Specialist works with insurance carriers regarding claim status and denial management. Follows Florida Orthopaedic Institutes policy and procedures along with applying federal and state guidelines to collection efforts. Interprets and follows up on Explanation of Benefits. Assuring timely collection of accounts receivable, monitoring the account activity and providing adequate follow- up to ensure maximum reimbursement is received. Maintaining Quantity & Quality of assigned work.
Key Responsibilities:
- Takes appropriate actions on denied charges to ensure claims are paid on the first follow-up call or appeal.
- Works with assigned queues, aging and denial reports to accomplish the set goal for the position.
- Responsible for learning, understanding and following payer guidelines.
- Notifying management of payer policy changes.
- Ensuring appropriate information is submitted to insurance companies in order to expedite payment.
- Completes appropriate adjustments and refund requests based on contract, modifiers or appeal denials.
- Handle incoming calls for information request from insurance companies and patients.
- Works to understand the operative notes that dictate procedures billed.
- Reallocate misapplied payments and adjustments.
- Work special assignments when needed.
- Utilizes the coding resources (CPT, ICD-10, CDR, AAOS books) to understand procedures that are denied.
- Documents accounts correctly.
- Assure compliance with all company plans, policies and procedures set forth by the Florida Orthopaedic Institute
- All other duties as assigned.
About You
- High School Diploma or general education degree (GED).
- Knowledge of medical terminology & medical billing. Insurance collection and denial process experience (minimum of 2 years)
- Excellent telephone etiquette and communication skills (written and verbal)
- Basic computer skills (Microsoft Office Suite, general EMR knowledge, payer website).
We Would Love It If You Also Had:
- Athena EMR experience
At FOI our goal is to provide our patients with world-class orthopedic care.
Our mission of providing the best care encompasses not only the care the physician provides, but all medical and administrative aspects of the patients encounter with Florida Orthopaedic Institute (FOI) as well. Every staff member plays a vital role in this mission. We take pride in receiving the Patriot Award from the Department of Defense for the support that we give to National Guard and Reserve members who are employed by FOI. We are committed to encouraging a culture of inclusion reflective of the communities we serve, and we provide equal opportunity to all. Florida Orthopaedic Institute conforms to the spirit as well as to the letter of all applicable laws and regulations.
What we offer:
- Full time opportunities available, with room for career growth and advancement.
- Excellent job security and stability, to promote an optimal work life balance.
- Be part of this dynamic and growing high level Revenue Cycle team
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