UB04 Senior Revenue Cycle Specialist/Insurance Follow-Up
1 month ago
Remote only for the state of Ohio
Responsible for submitting and resolving medical claims of moderate and high complexity for all Hospitals. This includes the handling of specialty billing claims, escalated accounts receivable concerns, and special projects for the health system.
Essential Duties:
• Utilizes work lists to review and analyze account balances in order to collect payment for medical services rendered.
• Utilizes multiple system applications to review and update patient billing information.
• Acts as a liaison with internal and external customers providing assistance in claims and receivables resolution in a high volume environment.
• Contacts patients and guarantors to secure necessary billing information.
• Documents accounts with clear and concise verbiage in accordance with departmental procedures.
• Reviews and responds to correspondence and inquiries received.
• Serves as subject matter expert and primary go to person for questions from junior level staff.
• Assists with the training and creation of process documentation.
• Assists management with special projects.
• In absence of management, may lead work flow efforts.
• Participates in or leads payer and/or departmental meetings as needed.
• Responsible for providing feedback suggestions and process improvement recommendations to management.
• Meets and exceeds team productivity and quality standards.
• Functions independently to analyze and resolve claims.
• Creates excel spreadsheets to analyze and resolve claims.
• Performs other duties as assigned
Qualifications:
Education:
• High School diploma or equivalent required.
• Associate's / Bachelor's Degree preferred.
Experience & Knowledge:
• 3+ years' medical billing / Accounting experience required.
• Must have a good working knowledge of claim submission (UB04/HCFA 1500) and third party payers.
• Knowledge of medical billing terminology required.
• Must be detail-oriented and organized, with good analytical and problem solving ability.
• Notable client service, communication, and relationship building skills required.
• Ability to function independently and as a team player in a fast-paced environment required.
• Must have strong written and verbal communication skills.
Special Skills & Equipment Knowledge:
• Demonstrated ability to use PCs, Microsoft Office suite (including Word, Excel and Outlook), and general office equipment (i.e. printers, copy machine, FAX machine, etc.) required.
• Exposure to medical billing software required
Preferred Qualifications:
At least 3 years of medical billing/claims experience is required. Must also have good working knowledge of UB40/HCFA1500 claims and third party payers, in addition to ICD10 coding. Also, Medicare MSP; Medicare On-Line/DDE experience is also preferred. This position will focus strongly on insurance follow-up.
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