Healthcare Operations Coordinator

5 days ago


Providence, Rhode Island, United States Brown Physicians, Inc. Full time
Job Description:
We are seeking a detail-oriented Revenue Cycle Specialist II to join our team at Brown Physicians, Inc. in [Location]. As a key member of our revenue cycle department, you will be responsible for ensuring the accuracy and efficiency of our medical billing processes.

Key Responsibilities:
  • Maintain current knowledge of federal and state regulations regarding medical billing practices.
  • Act as a resource to practice management and providers.
  • Maintain knowledge of all applications including eClinical Works, Epic, Microsoft Word, Excel and on-line payer verifications/claims status.
  • Submissions of claims to third party payers; ensure clean claim rates with submissions.
  • Identify trends within the Accounts Receivable.
  • Verifies completeness and accuracy of all claims prior to submission.
  • Timely follow up on insurance claim denials, exceptions or exclusions.
  • Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days.
  • Refund processing for third party payors and patients.
  • Research and analyze payments for discrepancies to companies and individuals.
  • Accurately post all insurance and patient payments. Reading and interpreting insurance explanation of benefits.
  • Make necessary arrangements for medical records requests, completion of additional information requests, etc. as requested by insurance companies.
  • Respond to inquiries from insurance companies, patients and providers.
  • Maintain patient confidentiality.
  • Demonstrate flexibility to perform duties wherever volume deems it necessary within the billing area.

Requirements:
  • A technical understanding of reimbursement policies and procedures of various third-party payor and medical assistance programs to ensure billing procedures are compliant.
  • Interpersonal skills to exchange information with patients, internal and external clients.
  • Understand the basic reporting and balancing.
  • Analytical ability to research and resolve billing problems, trending and to prepare statistical reports depicting billing activity.
  • Knowledge of insurance guidelines.
  • Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
  • Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
  • Provide feedback to Brown Physicians, Inc. practices surrounding error trends with demographics, eligibility, and etc.

Salary: $65,000 - $85,000 per year.

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