Revenue Specialist

4 weeks ago

Colorado, United States Sonora Quest Laboratories Full time
Job Summary

This position is responsible for coordinating and facilitating all insurance claim submissions, claim rejections, account refunds, complex adjustments, and collection activities. The ideal candidate will have extensive knowledge of billing, insurance, computer systems, and medical billing processes.

Key Responsibilities

1. Responsible for the collection, submission, and claim rejections for all assigned insurance accounts. Ensures all insurance payments and adjustments are posted in an accurate and timely manner in accordance with departmental policies, procedures, and performance goals.

2. Utilizes the Accounts Receivable Aging Reports to track and maintain balances within acceptable ranges prescribed by management.

3. Ensures all assigned insurance, regulatory, and patient correspondence is researched, resolved, and responded to in a timely, accurate, and professional manner as defined in departmental policies and procedures. Communicates with insurance company personnel as needed to facilitate the resolution of outstanding payment issues.

4. Ensures internal audits and quality controls are in place in accordance with departmental policies, procedures, generally accepted accounting practices, and all applicable laws and regulations. Interprets and resolves written and phone correspondence involving bill transfers, adjustments, credit balances, and refunds to facilitate prompt and accurate payments.

5. Understands and implements the contractual requirements for billing to and collecting from assigned insurance carrier(s).

6. Identifies and collaborates on improvements that can be made in the process of handling the insurance reimbursements area.

Requirements

• Two (2) years' medical claim collection experience with knowledge of insurance billing requirements and regulations.

• High School Diploma or equivalent.

• Ability to work independently and accurately with high volumes of data and minimal supervision and be able to interface with difficult patients and/or third-party insurance companies.

• Excellent communication skills, both written and verbal.

• Excellent organizational skills.

• Beginner level experience of Microsoft Excel.

Preferred Qualifications

• Extensive knowledge of clinical laboratory operations.

• Five (5) years' of medical billing/insurance related experience.

• Comprehensive knowledge of ICD-10 coding, CPT coding, HCPCS coding, modifiers, and government and commercial payer guidelines.

• Advanced working knowledge of both the Xifin billing system and Microsoft Excel.

EEO Statement

Sonora Quest Laboratories is an equal opportunity employer and welcomes applications from diverse candidates. Our organization supports a drug-free work environment.

Privacy Policy

Sonora Quest Laboratories is committed to protecting the privacy of our employees, patients, and customers. We comply with all applicable laws and regulations regarding the collection, use, and disclosure of personal information.

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