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Revenue Cycle Support

2 months ago

Mission Viejo, United States Coronis Health Full time
Job DescriptionJob Description

Job title

Revenue Cycle Support

Reports to

Revenue Cycle Manager

Classification

Hourly, Non Exempt

Job purpose

At the direction of the Revenue Cycle Manager, responsible for the follow-up on unpaid primary and

secondary claims, claim denials, underpaid and overpaid claims in accordance with established guidelines.

Duties and responsibilities

  • Execute follow-up on claims per MMGS and carrier protocols.
  • Identify root cause of claim denials and underpayments; process appeals in accordance with carrier policies.
  • Identify denial, underpayment, or other unpaid claim trends or patterns; report such trends and patterns to the
  • Revenue Cycle Specialist.
  • Perform balance and pending patient transfers and other related tasks.
  • Perform customer contact as overflow from the Patient Service Center
  • Maintain accounting of daily activities
  • Document notes in the billing system in accordance with protocols; ensure adequate detail and clarity of notes
  • Any other duties as deemed necessary by the Revenue Cycle Manager or other management.
  • Maintain a production of 40 claims per day for anesthesia claims, 35 claims per day for Pain claims
  • Maintain an accuracy of 95% on follow-up per audit guidelines
  • Seek first-time resolution on each claim
  • Any other performance requirements as deemed necessary by the Revenue Cycle Manager or other management.

Qualifications

  • Understanding of medical billing
  • Knowledge of billing practices and procedures; knowledge of carrier reimbursement policies and appeal procedures
  • Knowledge of HIPAA (legal and ethical consideration related to patient information)
  • High school diploma or equivalent
  • One (1) year experience in medical billing or equivalent experience or externship.
  • Excellent communication, organization, and time management skills
  • Proficient skills in computer programs; MMGS billing system, Word and Excel
  • Flexibility – willingness to help in other accounts and other areas as needed
  • Assertiveness – recognize problems, suggesting solutions and overall improvement of the service to MiraMed’s clients
  • Detail oriented
  • Ability to meet minimum production and accuracy standards
  • Ability to follow instructions and written guidelines in account specifics
  • Ability to understand and interpret policies and regulations
  • Ability to examine documents for accuracy and completeness
  • Ability to schedule time and assignments effectively
  • Attitude – be a team player with a willingness to cooperate and grow in experience

Additional information: Remote

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.

Coronis Health is committed to creating a diverse and inclusive environment where all employees are treated fairly and with respect. We are an equal opportunity employer, providing equal opportunities to all applicants and employees regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or any other protected characteristic. We welcome and encourage applications from candidates of all backgrounds.