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Revenue Cycle Specialist

2 months ago

Atlanta, Georgia, United States SENTA Partners Full time
Position Overview
As a Revenue Cycle Specialist at SENTA Partners, you will play a crucial role in managing the appeals process for denied claims. Your responsibilities will include:
  • Denial Research: Investigate denials to ascertain if there is a valid case for appeal.
  • Documentation Verification: Ensure all necessary documentation supporting the appeal is well-organized and complete, adhering to internal quality standards.
  • Appeal Letter Preparation: Draft and proofread appeal letters, ensuring they are free from errors and logically structured before submission.
  • Timely Submission: Submit appeals in accordance with internal protocols and deadlines.
  • Team Collaboration: Work closely with both internal and external stakeholders to address any inquiries or issues that arise during the appeal process.
  • Follow-Up: Monitor the status of all corrected claims and appeals submitted.
  • Account Notation: Maintain detailed records in the EMR system for all accounts processed.
  • Reimbursement Calculation: Estimate expected reimbursement amounts for claims.
  • Policy Knowledge: Maintain a comprehensive understanding of payor policy guidelines and contracts.
  • Fee Schedule Understanding: Have a clear grasp of relevant fee schedules.
Qualifications
  • High School Diploma required.
  • Preferred 2 years of relevant experience.
  • Strong verbal and written communication skills.
  • Exceptional organizational abilities and attention to detail.
  • Professional demeanor and friendly attitude.
  • Thorough knowledge of payor policies and guidelines.
  • Familiarity with coding standards.