Revenue Cycle Reimbursement Specialist

2 weeks ago

Valdosta, United States Azalea Health Innovations Inc Full time
Job DescriptionJob Description

IN SUMMARY...

The Revenue Cycle Reimbursement Specialist provides Revenue Cycle Management/Medical Billing services for Azalea clients and operates under the direct supervision of the Revenue Cycle Reimbursement Team Lead.

WHAT YOU WILL DO...

  • Responsible for insurance payment posting, denials management, and A/R follow-up for assigned accounts
  • Understands and calculates industry standard KPIs and benchmarks related to denials and AR management. Azalea performance benchmarks are set to outperform MGMA industry standards
  • Researches and analyzes denial data and coordinates denial recovery responsibilities.
  • Identifies, analyzes, and researches frequent root causes of denials and reports to management with possible action plans for resolution.
  • Prioritizes activities to work denials and AR in a strategic manner to avoid untimely filings.
  • Monitors insurance carrier networks issues (ex OON) and underpayments
  • Demonstrates a good working knowledge of CPT, ICD10, and HCPCS codes as well as remaining current on regulatory coding changes.
  • Leverages web portals, phone/fax communication, forms, and any other means necessary for denials and AR follow up
  • Ability to review and interpret clinical documentation/med records as it pertains to coding accuracy and support for claim reconsiderations and appeals
  • Maintains HIPAA compliance when handling patient protected health information (PHI)
  • Accurately explains denials management processes to other employees, clients, and third parties
  • Effectively monitors and audits aging and related RCM activities being performed by domestic and overseas subcontractors and partner companies.
  • Responsible for other Revenue Cycle Management-related duties,as assigned.

BACKGROUND AND SKILLS YOU WILL BRING...

  • Excellent ICD-10, CPT, and HCPCS coding knowledge & skills
  • Minimum 2 to 3 years experience in insurance payment posting and denials management preferred
  • Excellent computer and internet skills/instincts
  • Strong attention to detail
  • Strong oral and written communication skills
  • Diploma in Medical Billing/Coding Program preferred; CPC/CPB designation is a plus.

SUCCESS LOOKS LIKE...

  • Being aggressive and taking initiative; we trust you to move the needle forward
  • Doing the job; outcomes are just as important as strategy
  • Being adaptable and amenable to meet the changes of a dynamic and evolving industry
  • Demonstrating humility; partnership and collaboration is who we are and how we operate
  • Tapping into your innovative side; conventional is not always correct

HOW WE INVEST IN YOU...

  • Competitive and comprehensive benefits: Coverage options to support the whole person, including full medical, dental, vision, and life insurance
    • Generous employer sponsored subsidy towards employee's medical insurance premiums
    • Azalea Health covers 100% of the premiums for Life AD&D and Long-Term Disability for all eligible full-time employees
  • Balance and flexibility: Simple Paid Time Off (PTO) options. You earn your time, use it as you choose.
  • Economic opportunity: Competitive total rewards package that offers competitive pay and advancement opportunities

Azalea Health's EEO Statement

Azalea Health is an Equal Opportunity Employer committed to creating a diverse and inclusive workforce where our employees excel based on merit, qualifications, knowledge, ability, and job performance. We embrace and encourage our employees' differences in age, color, disability, ethnicity, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socioeconomic status, veteran status, and any other characteristics protected by federal, state, and local laws that make our employees unique.

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