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Revenue Cycle Management Specialist

2 months ago

Little Rock, United States HOMESTEAD PROPERTY MANAGEMENT SERVI Full time

Your Role The Revenue Cycle Management (RCM) Specialist will be responsible for the management of accounts receivable through collaboration with provider offices. Under the direction of the Manager, Operations and Enablement, the RCM Specialist will perform timely follow up and collection of unpaid charges, research policies, re-bill corrected claims, appeal denials, process refunds, and perform adjustments, among other tasks. The ideal candidate will have two years of experience in medical billing or experience in a general medicine, primary care, and/or internal medicine outpatient environment.

Primary Functions of the RCM Specialist Include:

Oversee revenue cycle and accounts receivable (AR) of multiple provider offices.

Analyze claim denials for coding or payor policy updates and make corrections as needed.

Review coding or documentation from providers that may need to be updated to release for billing.

Generate appeals or reconsideration forms on denied claims utilizing web portals or payor specific forms.

Help develop claim edits that will help increase cash flow and create clean claims.

Follow up on authorizations initiated by the front office staff, when necessary.

Research and provide timely response on patient, insurance and physician inquiries.

Communicate with provider offices to discuss accounts receivable issues, payment or denial trends and make recommendations to impact change.

Run denial and accounts receivable reports to help identify trends.

Coordinate with internal departments, escalate, and resolve payment issues.

Communicate with patients regarding billing issues, when requested.

Interact with external Revenue Specialists and practice billing teams to ensure appropriate and complete follow-up of patient accounts to maximize reimbursement.

Complete AR follow up processes, including claim corrections, appeals, payor follow up and resubmissions to expedite reimbursement relation to coding or other payor-based denials.

Analyze individual payor performances regarding fee schedule reimbursements and trends.

Perform other related responsibilities as assigned.

How You Qualify You reviewed the Who You Are section of this job posting and immediately felt the need to read on. This makes you a match for our innovative culture. You accept things change quickly in a startup environment and are willing to pivot quickly on priorities.

High school diploma required

2+ years of experience in medical insurance processing required

CPC/CCSP and CPB required (will consider one certification at time of hire, with the requirement that the candidate will obtain other certification within one year of hire)

2+ years of experience working in an outpatient General Medicine, Primary Care, and/or Internal Medicine environment required.

Proficiency in Athena Health highly desirable

Highly organized and detail oriented

Excellent oral and written communication skills, with ability to effectively communicate with all levels within the organization

Demonstrated ability to work in a fast-paced office environment.

Advanced Microsoft Office skills required; Microsoft Excel proficiency preferred

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