Revenue Cycle Specialist I

3 weeks ago


Providence, United States Brown Urology Full time
Job DescriptionJob Description

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Applies the Brown Medicine values of patient care priority, dignity, collaboration, integrity and quality in support of the Brown Medicine mission to deliver compassionate, high-quality patient care, research excellence and outstanding physician education. Is responsible for knowing and acting in accordance with the Brown Medicine Compliance Program and Code of Conduct.

Practices the Brown Medicine Customer Service Standards.

  • Maintain current knowledge of federal and state regulations regarding medical billing practices.
  • Act as a resource to practice management and providers.
  • Maintain knowledge of all applications including eClinical Works, Epic, Microsoft Word, Excel and on-line payer verifications/claims status.
  • Review encounter forms to ensure accurate diagnostic/treatment codes are entered into billing system.
  • Ensure data entry of encounter forms occur with two (2) business days of receipt.
  • Process all necessary adjustments or changes, as needed, to insurance information (including priority changes), demographic information.
  • Maintain patient confidentiality.
  • Demonstrate flexibility to perform duties wherever volume deems it necessary within the charge entry area.

BASIC KNOWLEDGE:

  • A technical understanding of reimbursement policies and procedures of various third-party payor and medical assistance programs to ensure billing procedures are compliant.
  • Interpersonal skills to exchange information with patients, internal and external clients.
  • Understand the basic reporting and balancing of charge batches.
  • Analytical ability to research and resolve billing problems and to prepare statistical reports depicting billing activity.
  • Provide feedback to Brown Medicine practices surrounding error trends with demographics, eligibility, and etc.

EXPERIENCE:

  • High school diploma, GED
  • One-two years of progressively more responsible experience in processing and resolving Revenue Cycle.



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