Revenue Cycle Specialist II

1 week ago


Houston, Texas, United States Senior PsychCare Full time
Job Summary

Senior PsychCare is seeking a skilled Revenue Cycle Specialist II to support our Billing Team in Houston. As a key member of our team, you will be responsible for processing follow-up actions on claims denied for eligibility-related reasons and responding to health plan correspondence.

Key Responsibilities
  • Manage and maintain a workload of approximately seventy (70) accounts or higher per day to ensure claim(s) resolution.
  • Review and attach appropriate documentation to resolve denied claims and submit appeals.
  • Call payers to determine the true reason for denial and inquire on what corrections need to be made.
  • Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or payer portals.
  • Review underpayments and overpayments, work with management to prepare spreadsheet and summarize findings; escalate as appropriate.
  • Prepare and submit denied claims targeted project files to payers, track reprocessing of project files.
  • Identify problematic claim trends and contract violations and report findings to the Manager and Director.
  • Update insurance information in the system as necessary, initiate and support primary, secondary and tertiary billing.
Requirements
  • 3+ years of recent Healthcare experience, specifically in a claims, Denials, billing, EOB and insurance verification.
  • Minimum 1+ years' experience in Government Payor follow-up.
  • Ability to work independently and prioritize monthly workflow.
  • Knowledge of Medical Terminology, CPT Codes, HCPCS, Revenue Codes, Modifiers and Diagnosis Codes.
  • Payer portal and clearinghouse experience.
What We Offer
  • Paid Time Off and Paid Holidays.
  • Comprehensive benefits packages including Medical, Dental, Vision, 401k, Long Term and Short-Term Disability, Life Insurance.


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