RCM Specialist

Trilogy Careers•Skokie, IL

1d•Onsite

About The Position

The Revenue Cycle Management (RCM) Specialist is responsible for timely submission of claims to insurance companies from a wide variety of medical providers and facilities and timely addresses denials. They will monitor, follow-up, and ensure that payments for medical services are received timely and paid in full. The RCM Specialist may function as an intermediary between healthcare providers, clients, patients, and health insurance companies.

Requirements

Must have received or be willing to receive the COVID-19 vaccination by the date of hire to be considered. Proof of vaccination required.
High school diploma or equivalent.
Educated on and compliant with HIPAA regulations.
Understand medical terminology and maintain strict confidentiality of patient and client information.
Strong understanding of Microsoft applications; i.e. Excel, Outlook, Word, PowerPoint
Ability to investigate problems and develop/communicate solutions
Excellent and professional customer service to internal and external customers.

Nice To Haves

Bachelor’s Degree in Business Administration, Accounting, or Health Care Administration preferred
Minimum 3 years of experience in the healthcare industry (particularly, working with Medicaid and Managed Medicaid insurance companies)
Medical billing, medical coding, medical administration certificate, or diploma program highly preferred
One to three years of training and experience in Revenue Cycle functions highly preferred
Experience with CareLogic system preferred

Responsibilities

Review client accounts for accuracy and completeness.
Obtain missing information and submit claims to insurance companies and other payer sources for payment.
Identify insurance company or correct guarantor (client) to be billed; identify and bill primary, secondary, or tertiary insurances.
Utilize a combination of client electronic health record and paper records to assist with billing and collections.
Maintain accurate and legally compliant health record.
Review insurance payments for accuracy and compliance with contract discounts.
Review denials or partially paid claims and work with involved parties to resolve discrepancies.
Manage assigned accounts ensuring outstanding/pending claims are paid in a timely manner and contact appropriate parties to collect payment.
Communicate with health care providers, patients, insurance claim representatives, and other parties to clarify billing issues and facilitate timely payment.
Consult supervisor, team members, and appropriate resources to solve billing and collection questions and issues.
Maintain work operations and quality by following standards, policies, and procedures; escalate compliance issues to Supervisor.
Prepare reports and forms as directed and in accordance with established policies.
Perform other related duties and/or projects as assigned

Benefits

FREE Virtual Primary Care, Urgent Care, and Mental Health Counseling for ALL Employees
PAID Maternity/Paternity leave
Medical Insurance (BCBS of IL)
Dental Insurance
Vision Insurance
Life Insurance
Long-Term & Short-Term Disability
Pet Insurance
FSA (Health, Dependent Care, Transit)
Telemedicine
EAP
403(b) Retirement Plan with Employer Match