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Revenue Cycle Specialist

2 months ago

Pensacola, United States Retina Specialty Institute Full time
Job DescriptionJob DescriptionGeneral Purpose of Job/Summary:The RCM Specialist for Retina Specialty Institute and Southern Eye Group is responsible for the meticulous identification, reconciliation, and processing insurance credits. This role demands a detailed review of patient accounts, collaboration with insurance companies, and ensuring the accurate and timely application of credits. The specialist will also address and resolve any discrepancies that arise. Essential Duties and Responsibilities:
  • SEG Patient Credits: Identify, reconcile, and process patient credits by reviewing patient accounts, managing credits, and ensuring accurate and timely application of credits. Resolve discrepancies promptly.
  • RSI/SEG Unpostables: Handle unpostables (insurance payments that cannot be posted due to missing information such as procedure codes, incorrect names, or missing remittance details) and resolve these issues to ensure precise financial processing.
  • SEG Missing Remits: Use payer portals and direct payer contact to obtain and accurately apply remittance information between payments received and the Practice Management system.
  • SEG Non-Practice Management Remits: Manage payments received outside of PM system (e.g., payments for previous providers that need to be posted in another PM) to maintain financial accuracy and reporting.
  • Reviews accounts and answers patients’ questions regarding billing discrepancies.
  • Update or change insurance on the account and submit corrected claims when applicable.
  • Return voicemails the same day.
  • Create cases in Practice Management when issues arise
  • Assist with other RCM projects as directed.
Education/Experience:
  • High School diploma or equivalent required.
  • Associate degree or higher preferred.
  • Previous medical billing experience required; experience in Ophthalmology/Optometry preferred.
Technical Skills:
  • Strong computer skills: Microsoft Word, Outlook, and Excel preferred
  • Strong clerical skills: typing, filing, and record keeping
Other Skills/Requirements:
  • Excellent interpersonal and communication skills (both verbal and written) required
  • Ability to adapt to multiple and rapidly changing priorities and deadlines
  • Work well under pressure and maintain a sense of urgency
  • Excellent organizational skills
  • Confident and capable communication with patients and coworkers
  • Handle Company business with the utmost professionalism, discretion, and tact
  • Friendly, helpful team player with a positive, customer-service attitude
  • Good collaboration and problem-solving skills
  • The ability to work independently and productively with little or no supervision
  • Dependable and reliable
  • Exercise good judgment and take initiative to properly address and resolve issues
  • Keep supervisor and coworkers informed of the status of issues and projects
Physical Requirements:

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions to the extent the Company may do so without undue burden.

While performing the duties of this job, the employee will regularly be required to:

  • Sit for prolonged periods at a desk while working on a computer

While performing the duties of this job, the employee will occasionally be required to:

  • Stand
  • Walk
  • Stoop, kneel, crouch, and/or crawl
  • Lift and/or move up to 15 pounds
Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Climate controlled, temperate indoor working environment
  • The noise level in the work environment is usually moderate
Other Duties:

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.