Revenue Cycle Associate

PRIMARY FUNCTION:

This role is pivotal in overseeing and enhancing the daily operations of all billing functions. The main responsibility involves managing a list of insurance and patient claims with outstanding balances. You will address customer service inquiries related to billing via phone or in-person, facilitate the collection of personal payment balances, handle denials, coordinate with collection agencies, establish and monitor payment plans, and process bankruptcy notifications and returned checks.

NATURE AND SCOPE:

Reporting Relationship

This position reports directly to the Finance Manager at Exodus Health Care Network.

Functions Exclusively Performed by Incumbent:

The incumbent is accountable for collections within the Exodus Health Care Network and other responsibilities as assigned by the Finance Manager or Billing Team Leader.

Internal and External Contacts:

Engages with all personnel within the Exodus Health Care Network.

MAJOR POSITION RESPONSIBILITIES:

• Ensure all charges are complete and accurate, including proper coding, pricing, and ICD-10 diagnosis codes.
• Perform data entry and reconciliation of all billing into the billing system.
• Submit electronic claims, including setup, maintenance, and liaising with insurance carriers for issue resolution.
• Manage the assigned claims worklist in Athena, including Holds, Manager Holds, and Overpaid claims.
• Assist with various billing and collection projects as needed.
• Serve as the customer service contact for inquiries from patients regarding account balances and insurance matters.
• Conduct weekly Best Practice assignments in Athena.
• Manage Overpaid Claim Worklist, Insurance Refunds, Patient Unapplied Credit Worklist, Patient Refunds, Refunds in Process, Self-Pay Account Worklist, Collections Worklist, Zero Pay Review, Payment Mismatch Wizard, Fully Worked Receivables, Claim Attachment Error Queue, and Unpostable/Correspondence.

EDUCATION:

• High School Diploma.

JOB REQUIREMENTS:

• Proficient knowledge of ICD-10 and CPT terminology.
• Familiarity with Athena Healthcare software.
• Understanding of hospital billing processes.
• Knowledge of third-party billing practices.
• Experience with electronic billing procedures and related reports.
• High-level accuracy in data entry.
• Minimum typing speed of 50 words per minute.
• Strong customer service and telephone etiquette skills.
• Comprehension of billing and collection methodologies.
• Experience in managing collections and bankruptcy situations.

EXPERIENCE:

• Exceptional interpersonal communication skills.