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Revenue Cycle Specialist
2 months ago
JOB TITLE: Revenue Cycle Specialist
DEPARTMENT: Healthcare Vertical: ACS
REPORTS TO: Manager and/or Area Manager
SUPERVISORY RESPONSIBILITIES: no
JOB LOCATION: Varies
TRAVEL: no
SUMMARY OF POSITION: Responsible for processing, reviewing, and filing insurance to the resolution of claim payment and assist the inquiry team with billing questions from guarantors about account balances.
ESSENTIAL DUTIES & RESPONSIBILITIES:
- Performs various functions in the processing of insurance billing and collections, including Medicaid/Medicare claims according to the established policies and procedures and in compliance with HIPAA. Many clients' accounts require team effort while other accounts may require independent workers to complete all aspects of the billing process. Employees’ may be responsible for multiple accounts with functions varying with each account. Assignment of accounts may fluctuate as ACS Client base changes.
- Reviews, verifies, and submits insurance claims.
- Processes correspondence from Third Party Payors and responds to requests.
- Follows-up with insurance companies and ensures claims are paid properly and in a timely manner.
- Investigate insurance claims that have received no response and resubmit if necessary.
- Claim rejection handling.
- Filing claim appeals with insurance companies to ensure maximum reimbursement.
MINIMUM QUALIFICATIONS (EDUCATION AND EXPERIENCE):
- High School diploma or GED
PREFERRED QUALIFICATIONS (EDUCATION AND EXPERIENCE):
- Knowledge of medical terminology.
- Knowledge of the medical insurance industry.
- Familiar with CPT and ICD-10.
- Skill in using computer programs and applications (Word, Excel, etc.)
- Excellent customer service skills.
- Strong written and verbal communication skills
- Ability to read, understand, and follow oral and written instructions.
- Ability to communicate clearly and concisely.
- Ability to establish and maintain effective working relationships with patients, employees, various insurance payers, and the public.
- Ability to multi-task, work independently and as a team as well as courteously and respectfully with fellow employees, clients, and patients.
- Ability to prioritize workload and manage multiple responsibilities effectively.
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice.
