Revenue Cycle Specialist

2 weeks ago


Fort Worth, United States Jet Health Full time
Job DescriptionJob DescriptionDescription:

The Revenue Cycle Specialist (RCS) will be responsible for overseeing critical financial tasks such as billing, collections, and claims management in accordance with state and federal regulations. The RCS will work with various payor portals to monitor and track payment, claim status, and contact payor sources to resolve claim issues. This position will work with various members of the finance and operations teams to ensure that billing and claims data is reported regularly.

Requirements:

Essential Duties and Responsibilities:

  • Monitor and maintain assigned accounts by completing daily billing tasks and ensure minimal write offs of reimbursement dollars.
  • Collect all necessary information to prepare claims and follow-through with corrections, resubmission, or appeals to resolve balances.
  • Submit clean claims to various insurance companies, complete submissions electronically or by paper according to payor guidelines.
  • Research, correct, and resubmit rejected and denied claims.
  • Prepare appeals to all denied claims.
  • Review and interpret remits or EOBs to determine claim issues and take steps to rectify claim balances.
  • Oversee the end-to-end billing process while ensuring accuracy, efficiency, and compliance with regulatory requirements.
  • Stay abreast of changes in healthcare reimbursement policies and proactively adjust strategies to align with industry standards.
  • Partner with Finance to analyze reimbursement impacts on financial performance and support budgeting processes.
  • Manage billing and collection performance to meet or exceed company goals Minimize adjustments with timely identification of outstanding orders and other documentation that can negatively impact revenue recognition.

Qualifications:

  • High School Diploma or equivalent.
  • Minimum 2+ years’ experience in home health or hospice billing.
  • Must have knowledge and experience in Medicare and Medicare Secondary billing.
  • Strong computer and software skills.
  • Excellent written and verbal communication skills.
  • Ability to collaborate with cross functional departments.
  • Must be solutions oriented and have excellent problem-solving skills.

Physical Requirements:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Duties of this job are performing the following:

  • Ability to sit for extended periods of time, approximately 50% of work time.
  • Ability to stand and walk, approximately 50% of work time.
  • Ability to bend, push, pull, stoop, reach, and kneel approximately 30% of work time.
  • Ability to lift up to fifty pounds.
  • Ability to operate computer, facsimile, copier, shredder, and calculator.
  • Ability to travel by mode of car, airplane, train and bus.
  • Normal business hours with flexibility to work overtime or non-standard hours as required by travel and special projects.


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