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Revenue Cycle Specialist

2 months ago

Lafayette, United States i3 Verticals Full time

JOB TITLE: Revenue Cycle Specialist

DEPARTMENT: Healthcare Vertical

REPORTS TO: RCM Manager

SUPERVISORY RESPONSIBILITIES: no

JOB LOCATION: varies

TRAVEL: no

SUMMARY OF POSITION: We are seeking a Revenue Cycle Specialist to join our team. The Revenue Cycle Specialist will be responsible for accurately processing medical billing claims, reviewing and resolving any billing discrepancies, and ensuring timely reimbursement from insurance companies. This role requires strong attention to detail, proficiency in medical terminology, and the ability to work independently and collaboratively in a fast-paced environment.

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 the Compliance and HIPAA Policies & Procedures Manuals. 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 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. * DuxWare software knowledge is a plus.

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.