Revenue Cycle Management Specialist

1 month ago

Paramus, New Jersey, United States Advanced Data Systems Full time
Job Summary

We are seeking a highly motivated and detail-oriented Jr. Account Manager to join our Revenue Cycle Management team at Advanced Data Systems. As a key member of our team, you will be responsible for ensuring the productivity of workflow within a functioning team, communicating effectively to ensure a concrete workflow that increases practice revenue, and reporting to the Sr. Account Managers on all aspects of the account.

Key Responsibilities
  • Ensure timely and proper payments from all payers.
  • Follow up on any outstanding items and client issues, identifying and quickly rectifying any issue that interrupts the Revenue Cycle for clients.
  • Initial escalation points for all lead issues within the assigned team.
  • Assist the Sr. Account Manager in all aspects of training regarding assigned team members.
  • Coordinate weekly and daily calls with the assigned team on open items.
  • Ensure that the payment poster's issues within the portfolio are tracked and resolved.
  • Ensure that the denial team's issues within the portfolio are tracked and resolved.
  • Review monthly close reports to ensure that all payments have been applied correctly assigned accounts.
  • Run the End of the Month Reconciliation with the Sr. Account Managers.
  • Report to upper management on items not resolved by Sr. Account Managers in a timely manner.
  • Maintain strict patient confidentiality/HIPAA compliance.
  • Maintain knowledge of ICD9/ICD10 diagnostic as well as CPT/HCPCS procedural coding.
  • Maintain thorough knowledge of insurance carriers and their claim guidelines/requirements.
  • Guide the team to meet the metrics (production targets) and enable faster resolution in case the targets are not met.
  • Regularly evaluate a set % of payments posted /A/R worked for correctness and ensures that the policies are applied.
  • Follow up on invoices submitted whenever necessary in case of resource crunch.
  • Assist in creating and updating Collection training modules & train new and existing employees.
  • Make calls to troubleshoot payment discrepancies and establish resolution.
  • Document, in detail, phone calls, including phone numbers, person spoken to, and call details on a consistent basis. (Who, What, When, Where & Why)
  • Resolve issues that created a denial within 5 days of receipt of denial.
  • Interact with others in a positive, respectful, and considerate manner.
Requirements
  • Must have a minimum of 2 years of experience with Revenue Cycle Management/Medical Billing.
  • Knowledge of Practice Management Systems. Medics Premier and/or Medics Elite experience a plus.
  • Experience with electronic claim submission via Clearinghouse. Emdeon/ Change Healtcare experience a plus.
  • Billed for multiple specialties.
  • Billed for both Professional and Institutional claims with a solid understanding of HCFA-1500 and UB-04 claim forms as well as the electronic equivalent.
  • Processed ERAs.
  • Enrolled EDI.
  • Excellent oral and written communication skills.
  • Experience with provider credentialing a plus.

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