Healthcare Revenue Cycle Management Specialist

2 weeks ago


Deerfield Beach, Florida, United States FHE Health Full time
Job Overview

FHE Health is a distinguished healthcare provider dedicated to delivering high-quality, integrated treatment for individuals facing Behavioral Health Disorders. Our institution is committed to serving the community with compassion and expertise, focusing on a range of conditions including addiction, depression, anxiety, and trauma-related disorders.

Position Summary

We are currently seeking a skilled Healthcare Revenue Cycle Management Specialist with a strong background in Physicians Group Collections. This role reports directly to the Director of IRCM and is essential for ensuring the financial health of our organization.

Benefits Offered

As a full-time Healthcare Revenue Cycle Management Specialist, you will have access to a comprehensive benefits package, including:

  • Medical Insurance
  • Dental Coverage
  • Vision Plans
  • Supplemental Life Insurance
  • Disability Insurance
  • 401(k) Retirement Plan
  • Paid Time Off
  • Vacation Leave
  • Employee Assistance Program

Key Responsibilities

Under the guidance of the Director of IRCM, the Healthcare Revenue Cycle Management Specialist will be responsible for:

  • Managing collections for the Physicians Group.

This position is ideal for candidates looking for a full-time role, Monday through Friday.

Qualifications and Skills

  • High School Diploma or GED required.
  • Current CPR Certification or willingness to obtain.
  • Crisis Prevention Intervention (CPI) Training or willingness to obtain.
  • A minimum of 2 years of experience in healthcare billing and collections, specifically within addiction or behavioral health treatment settings.
  • Strong understanding of insurance protocols.
  • Proficient in computer systems, software applications, and 10-key calculators.
  • Familiarity with CPT, ICD-10 coding, and ASAM criteria.
  • Excellent communication skills for effective interactions with insurance payers.
  • Customer service aptitude for engaging with patients regarding medical claims and payments.
  • Ability to collaborate effectively within a team environment, prioritize tasks, and manage conflicts constructively.
  • Strong problem-solving skills to address discrepancies, denials, appeals, and collections.
  • Preferred certifications include CPC, CSS, CAA, COC, CBP, CMC, CBCS, though not mandatory.

Essential Functions

  • Prepare, enter, and review claims prior to reconciliation.
  • Process claim corrections identified during reconciliation.
  • Experience with coding, including CPT/HCPC, Revenue, and Diagnosis codes.
  • Familiarity with 1500 HCFA and UB04 claim forms.
  • Prepare, review, and transmit claims using billing software, including both electronic and paper submissions.
  • Utilize billing software to review claim rejections, correct errors, and resubmit claims.
  • Follow up on unpaid claims within the standard collection cycle timeframe.
  • Verify the accuracy of insurance payments in accordance with contractual agreements.
  • Contact insurance companies to resolve payment discrepancies and underpayments.
  • Identify and bill secondary or tertiary insurance providers.
  • Review accounts with outstanding balances to determine next steps, including potential collections.
  • Research and appeal denied claims as necessary.
  • Respond to patient or insurance inquiries related to assigned accounts.
  • Transfer patient collection calls to the appropriate department.


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