Revenue Cycle Specialist - Patient Business Services

Job Description

POSITION SUMMARY:

The Revenue Cycle Specialist I will be responsible for the review and follow up of Third Party Claims Reimbursements to include the identification, billing and collection of payments. The Revenue Cycle Specialist I will actively engage with other departments to ensure timely resolution of all outstanding accounts to ensure maximum reimbursement.

PRIMARY ACCOUNTABILITIES:

1. Apply general knowledge of third party claims reimbursement practices
2. Understand, interpret and appropriately handle basic insurance correspondences
3. Verify insurance and benefits through understanding of payer websites and vendor applicable systems
4. Maintain established quality assurance and productivity benchmarks while utilizing best practice standards established.
5. Process all referrals in timeframe established by department
6. Update account accurately in all systems to reflect work being performed
7. Apply logic and common sense to identify payer trends.
8. Communicate identified payment trends to leadership promptly and accurately
9. Ensure compliance with state and federal laws regarding all aspects of role.

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities.

Qualifications:

MINIMUM QUALIFICATIONS:

• Education: High School Diploma or equivalent required.
• Licensure: None Required.
• Certification: None Required.
• Work Experience in Related Field: None.
• Work Experience in Lieu of Degree: N/A.
• Knowledge/Skills/Abilities: Microsoft Office - Outlook, Word, Excel, PowerPoint.

PREFERRED QUALIFICATIONS:

• Education: None additional required.
• Licensure: None.
• Certification: None.
• Work Experience in Related Field: One year experience in Healthcare Billing and /or AR follow up or related field.
• Work Experience in Lieu of Degree: N/A.
• Knowledge/Skills/Abilities: Critical thinking, Decision-making skills.

PHYSICAL REQUIREMENTS: Sedentary - Office Workers

• Sedentary work involves sitting most of the time.
• Walking and standing or lifting more than 10 pounds are required only occasionally.
• Must be able to tolerate long periods of computer time a day.
• Must be able to tolerate long periods of phone time a day.
• Ability to enter information using hand/wrist dexterity.
• Visual acuity and hand-eye coordination to preform various tasks.