Senior Revenue Cycle Specialist

2 weeks ago

Phoenix, Arizona, United States Team Select Home Care Full time
About the Role

We are seeking a highly skilled Senior Revenue Cycle Specialist to join our team at Team Select Home Care. As a key member of our Revenue Cycle Management (RCM) team, you will play a critical role in ensuring the timely and accurate reimbursement of medical claims.

Key Responsibilities
  • Claim Denials and Appeals: Investigate and resolve claim denials and appeals in a timely and efficient manner.
  • Claim Coordination: Coordinate claim activities and designated agencies to ensure timely reimbursement of receivables.
  • Secondary and Tertiary Insurances: Review and bill all secondary and tertiary insurances to correct charges, bill forms, and supporting documentation (EOBs).
  • Net Collections and Outstanding Receivables: Achieve and maintain net collections and outstanding receivables goals as defined by company objectives.
  • Trend Analysis: Identify trends related to denials/coding and delinquent claims and communicate effectively with client managers for feedback to clients.
  • System and Payer Issues: Identify system/payer issues such as rates, codes, set up, and coordinate accordingly.
  • Account Status and Issues: Report status of accounts and issues to appropriate supervisors and departments, maintaining full transparency of accounts.
  • Full Cycle Resolution: Follow requirements through the full cycle until accounts are satisfied, including patient collections and appeals.
  • Write-Offs and Adjustments: Document, process, and coordinate all write-offs and adjustments as needed.
  • Payer and Contracting Issues: Work with contracting teams and management to resolve payer issues.
  • Branch Support: Work with branches for all questions on accounts.
  • System Troubleshooting: Troubleshoot system issues and work to resolve issues.
  • Process Improvement: Responsible for ongoing process improvement.
  • Coverage and Cross-Training: Coordinate coverage and cross-training for the team.
  • Regular Meetings: Attend regular meetings with teams and management to ensure open communication.
  • Ongoing Training and Mentorship: Ongoing training and mentorship with team.
  • Critical Accounts and Projects: Handle critical accounts and projects, coordinating with management, operations, and payers to ensure issues are resolved.
  • AR Meetings: Lead AR meetings with management, branches, and staff as required.
  • Project Oversight: Oversee projects for the full cycle of gathering data to submission and resolution from payor.
  • Data and Trend Analysis: Gather data and trends to report to leadership for delays in payments and collections issues.
  • Resource and Training: Act as a resource for existing locations for RCM team.
  • New Location Research: Lead research of new locations, acquisitions, and work to ensure timely billing and collections for these locations.
  • Training and Knowledge Transfer: Train RCM staff for new locations and acquisitions to ensure accuracy and knowledge of team.
Qualifications
  • Education: High School diploma
  • Experience: 2+ years of medical collections experience

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