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Revenue Cycle Management Specialist

1 month ago

Nashville, United States Honest Medical Group Full time
Job DescriptionJob DescriptionWho You Are

You are devoted, compassionate, and enjoy being on the front lines in healthcare, changing the lives of your patients. You are passionate about getting to the root cause of a patient's conditions, removing social determinants of healthcare, and ensuring the highest possible quality of life for those in your care. You don't want to sacrifice quality over quantity, and you aim to provide the same level of care and commitment to your patients that you would to your own family member.

Does this sound like you? If so, we should talk.

Who We Are

We are Honest Medical Group, a groundbreaking team of health care professionals focused on making a major impact in health care. At Honest, we align every aspect of our company to support patients and providers. We are devoted to purpose and inspired by innovation. We embrace our communities and lead with kindness. We drive health improvements, create a seamless member experience, and eliminate unnecessary cost. We listen to the needs of our patients and our employees—continually working to push beyond the status quo.

For us, it's all in an Honest day's work.

Your Role

The Revenue Cycle Management (RCM) Specialist will be responsible for the management of accounts receivable through collaboration with provider offices. Under the direction of the Manager, Operations and Enablement, the RCM Specialist will perform timely follow up and collection of unpaid charges, research policies, re-bill corrected claims, appeal denials, process refunds, and perform adjustments, among other tasks. The ideal candidate will have two years of experience in medical billing or experience in a general medicine, primary care, and/or internal medicine outpatient environment.

Primary Functions of the RCM Specialist Include:
  • Oversee revenue cycle and accounts receivable (AR) of multiple provider offices.
  • Analyze claim denials for coding or payor policy updates and make corrections as needed.
  • Review coding or documentation from providers that may need to be updated to release for billing.
  • Generate appeals or reconsideration forms on denied claims utilizing web portals or payor specific forms.
  • Help develop claim edits that will help increase cash flow and create clean claims.
  • Follow up on authorizations initiated by the front office staff, when necessary.
  • Research and provide timely response on patient, insurance and physician inquiries.
  • Communicate with provider offices to discuss accounts receivable issues, payment or denial trends and make recommendations to impact change.
  • Run denial and accounts receivable reports to help identify trends.
  • Coordinate with internal departments, escalate, and resolve payment issues.
  • Communicate with patients regarding billing issues, when requested.
  • Interact with external Revenue Specialists and practice billing teams to ensure appropriate and complete follow-up of patient accounts to maximize reimbursement.
  • Complete AR follow up processes, including claim corrections, appeals, payor follow up and resubmissions to expedite reimbursement relation to coding or other payor-based denials.
  • Analyze individual payor performances regarding fee schedule reimbursements and trends.
  • Perform other related responsibilities as assigned.

How You Qualify

You reviewed the Who You Are section of this job posting and immediately felt the need to read on. This makes you a match for our innovative culture. You accept things change quickly in a startup environment and are willing to pivot quickly on priorities.

  • High school diploma required
  • 2+ years of experience in medical insurance processing required
  • CPC/CCSP and CPB required (will consider one certification at time of hire, with the requirement that the candidate will obtain other certification within one year of hire)
  • 2+ years of experience working in an outpatient General Medicine, Primary Care, and/or Internal Medicine environment required.
  • Proficiency in Athena Health highly desirable
  • Highly organized and detail oriented
  • Excellent oral and written communication skills, with ability to effectively communicate with all levels within the organization
  • Demonstrated ability to work in a fast-paced office environment.
  • Advanced Microsoft Office skills required; Microsoft Excel proficiency preferred

How You are Supported
  • As a full-time team member, you will benefit from Honest's exceptional total rewards package, including competitive base pay with bonuses, paid time off starting at 4 weeks for full time employees, 12 paid holidays per year, reimbursement for continuing medical education, 401k with match, health, dental, and vision insurance.
  • Family friendly policies that support paid parental leave and flexible work arrangements
  • As a team member you'll be supported by our robust commitment to training and development that starts with onboarding and continues throughout your career with Honest.
  • You will collaborate with like-minded healthcare professionals who, like you, understand the importance and value of Honest's high-quality, value-based, care model.

Honest is an equal opportunity employer that is committed to inclusion and diversity. We take affirmative action to ensure equal opportunity for all applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics.

Honest is committed to working with and providing reasonable accommodations to job applicants with physical or mental disabilities. Applicants with a disability who require a reasonable accommodation for any part of the application or hiring process should email talent@HonestMedicalGroup.com for assistance. Reasonable accommodation will be determined on a case-by-case basis.

Honest Medical Group contacts candidates via various platforms, including Honest's recruiting platform and/or email or text message. If working with candidates directly, Honest will contact candidates using an honestmedicalgroup.com email address. For reference, the recruiting process will always include a live phone call and/or real person interview prior to making a formal offer of employment. Honest will never ask for an individual's confidential personal information or financial account information (i.e., social security number or bank account and/or routing number) prior to a formal offer and will never ask for transfers of money or financial information by email, text, Venmo, or other social media. Further, Honest will never request financial account security information (i.e., PIN number, password, or security access information). We encourage all candidates to be diligent in their job search and to verify the contact information of individuals they are working with. If there are any questions as to whether a communication is coming from Honest, candidates may reach out to talent@honestmedicalgroup.com.