RCM Specialist

OneOncology

95d

About The Position

The Revenue Cycle Specialist works under the direct supervision of the Sr. Director, RCM Shared Services and is responsible for a wide range of revenue cycle processes. The individual will need to have expertise in medical coding, insurance billing, and payment posting. The successful candidate will work closely with RCM leadership, patients, physicians, and insurance companies to ensure that accurate and timely billing and payment reconciliation is completed.

Requirements

• High School diploma or equivalent required
• Bachelor’s degree preferred
• One year of experience in direct related role

Nice To Haves

• Alpha Numeric data entry experience with speed and accuracy required
• Ability to efficiently and effectively work in a production environment
• Proficient in the use of end-user computer applications regarding productivity (MS Word, Excel, Outlook), database and patient billing and other medical information systems
• Ability to operate various types of office equipment
• Ability to work effectively with all levels of management and other colleagues, demonstrating initiative and mature judgment
• Excellent customer service skills
• Effective verbal and written communications, including active listening skills and skills in presenting findings and recommendations
• Careful attention to detail
• Keen problem-solving skills
• Must possess high degree of professionalism and adaptability
• Knowledge of medical billing, HCPCS, CPT and ICD codes
• Scanning experience

Responsibilities

• Confirm insurance benefits and eligibility for patients as required
• Ensure that claims for all services rendered are submitted to the payers within the timely filing guidelines of each individual payer with minimal errors
• Communicate openly with clinical staff and RCM teams to ensure timely and accurate billing is completed
• Monitor and track claims through the billing process to ensure timely payment and identification of payer roadblocks
• Identify and work items to resolution in various statuses within the Practice Management system daily
• Review, interpret and apply knowledge of billing guidelines and medical policies
• Train with team members or other employees when assigned by management
• Recognize problems or trends and provide suggestions to help find resolutions
• Deliver timely responses to emails and telephone messages as appropriate
• Follow policies and procedures outlined by RCM leadership to ensure standardization of processes
• Prepare lock boxes and posts payments from EOBs received the prior day, meeting daily quota outlines with minimal errors
• Run daily balancing reports and review/correct discrepancies prior to day close procedures
• Work offset and clear accounts in a timely manner to eliminate balances in these transition accounts
• Advise supervisor of any insurance issues as they are identified on EOBs that need attention
• Provide medical records securely to payers upon request
• Operate electronic posting downloads along with manual postings daily
• Document work completed
• Maintain a general understanding of HCPCS/ICD/CPT oncology coding and carrier requirement knowledge
• Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer.

What This Job Offers

• Education Level: High school or GED