Medicare Billing

Job DescriptionJob Description

Primary Accountability

The Revenue Cycle Specialist II will assist the Revenue Cycle Director and the Revenue Cycle Manager in operations.

Primary Responsibilities

1. Assist the Revenue Cycle Director in monitoring operations, including:

• 1.1. The monthly report of un-dropped charges in the doctors’ report.
• 1.2. Unapplied credit balances.
• 1.3. Patient payment refund.
• 1.4. Insurance verification for newborn hospital encounters.
• 1.5. Report on newborn hospital encounters.
• 1.6. Verification of Medicaid eligibility.

2. Assist the Revenue Cycle Director in monitoring staff to ensure accuracy and promptness of their tasks, specifically, reviewing work on:

• 2.1. Verify MBCHC patients’ insurance coverage for next-day appointments or walk-ins.
• 2.2. Providing training to MBCHC staff on effective insurance verification as needed.
• 2.3. The Insurance Verification reference sheet that outlines instructions by insurance plans.
• 2.4. Collection projects.

3. Assist the Revenue Cycle Director in reviewing the denials and rejections of insurance claims to assess patterns.

4. Assist the Revenue Cycle Director in determining how to reduce or eliminate insurance rejections and denials.

5. Assist the Revenue Cycle Director with the responsibilities associated with human resource functions.

6. Assist the Revenue Cycle Director in training staff on finance functions as needed.

7. Assist the Revenue Cycle Director in determining how best to maximize cash flow while maintaining and improving internal and external customer relations.

8. Assist the Revenue Cycle Director in serving as a key resource in all matters relating to billing.

Primary Attributes

1. General Development

• 1.1. Able to juggle multiple priorities.
• 1.2. Able to adjust to changing circumstances.
• 1.3. Able to organize time efficiently.
• 1.4. Able to serve as a liaison between patients and medical staff.
• 1.5. Maintain cordial relationships with staff, patients, and community members.

2. Professional and Technical Knowledge

• 2.1. Knowledge of insurance company practices regarding reimbursement and healthcare receivables.
• 2.2. At least 1 year experience at a federally qualified health center

3. Technical Skills

• 3.1. Proficiency in Microsoft Office Suite, especially Excel.
• 3.2. Able to use clerical and numerical skills in preparing drafts and documents from raw data.
• 3.3. Able to create letters, forms, and documents.

4. Communication Skills

• 4.1. Excellent written and oral communication skills.
• 4.2. Communicate complex concepts clearly and effectively to a general audience.

We are preferably seeking individuals with extensive experience in insurance verifications and a strong understanding of various insurance carriers.

Company DescriptionMiami Beach Community Health Center, Inc. (MBCHC) is a fully integrated ambulatory care medical facility that has been providing primary health care in Miami-Dade County since 1977. Our mission is to provide our patients with a patient-centered medical home with high quality, affordable primary health care, and specialty services, chronic disease management, and support services.

MBCHC has two locations on Miami Beach and one in North Miami. Services provided include internal medicine, family medicine, pediatrics, obstetrics and gynecology, HIV/AIDS services, dental, endocrinology, ophthalmology and optometry, psychiatry and behavioral health, podiatry, and geriatrics. All three locations have laboratory and pharmacy services. MBCHC pharmacies have 340B pricing. Free medication is available for patients through pharmaceutical company patient assistance programs for those who qualify. Free transportation and translation services are also available for those who need them. In addition, we offer assistance with case management such as enrollment in health insurance from the Affordable Care Act (“Obamacare”), enrollment in Medicare, and Healthy Start prenatal services.Company DescriptionMiami Beach Community Health Center, Inc. (MBCHC) is a fully integrated ambulatory care medical facility that has been providing primary health care in Miami-Dade County since 1977. Our mission is to provide our patients with a patient-centered medical home with high quality, affordable primary health care, and specialty services, chronic disease management, and support services.\r
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MBCHC has two locations on Miami Beach and one in North Miami. Services provided include internal medicine, family medicine, pediatrics, obstetrics and gynecology, HIV/AIDS services, dental, endocrinology, ophthalmology and optometry, psychiatry and behavioral health, podiatry, and geriatrics. All three locations have laboratory and pharmacy services. MBCHC pharmacies have 340B pricing. Free medication is available for patients through pharmaceutical company patient assistance programs for those who qualify. Free transportation and translation services are also available for those who need them. In addition, we offer assistance with case management such as enrollment in health insurance from the Affordable Care Act (“Obamacare”), enrollment in Medicare, and Healthy Start prenatal services.

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