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Revenue Cycle Specialist
2 months ago
Metis Practice Solutions is seeking a highly skilled Revenue Cycle Specialist to join our team. As a Revenue Cycle Specialist, you will play a critical role in supporting our business by proactively working on accounts receivable, including follow-up, appeals, and denials. You will utilize complex problem-solving skills to contribute to the organization's revenue.
Key Responsibilities- Generate revenue by working with patient accounts, including making payment arrangements, collection on accounts, and monitoring and pursuing delinquent accounts.
- Provide exceptional customer service by answering incoming patient billing and health plan inquiries on a daily basis.
- Make outbound and inbound phone calls to insurance companies to verify insurance eligibility and benefits.
- Verify claim status, including working on denials and appeal status.
- Verify patient statements to ensure accuracy before sending documents to patients.
- Maintain work operations by following policies and procedures and reporting compliance issues.
- Maintain confidentiality and adhere to HIPAA regulations.
- Utilize problem-solving skills to research and resolve discrepancies, denials, appeals, and collections.
- Adhere to professional standards, policies, and procedures, as well as federal, state, and local requirements and standards.
- Triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
- Enhance billing departments and practice reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.
- High School diploma required.
- Medical Insurance billing certificate preferred.
- 1-3 years medical billing experience.
- 1-3 years customer service experience preferred.
- Comfortable using math processes.
- Proficiency with electronic practice management (EPM) and electronic medical records (EMR).
- Knowledge of Microsoft Office products.
- Knowledge of insurance guidelines, including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
- Knowledge of CPT/ICD/HCPS coding.
- Knowledge of medical terminology and HIPAA regulations.
- Ability to multitask and prioritize well.
- Competent use of computer systems, software, and 10-key calculators.
- Excellent written and verbal communication skills.
- A calm manner and patience working with patients or insurers.
- High level of customer service.
- Ability to work well in a team environment.
- Able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
- Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections.
- The ability to maintain a high level of confidentiality.
- Adhere to all company policy and procedures.
