Revenue Cycle Interventional Radiology Specialist

Advanced Radiology Consultants•Shelton, CT

48d•Onsite

About The Position

Join our Culture of Caring! This is a full time, in person position based on site at our Shelton Business Office. Mission: With every action we take, Advanced Radiology Consultants is committed to building and maintaining the trust of our referring physicians and providing our patients with exceptional care. Advanced Radiology is one of the largest independent radiology practices in the tri-state area with the most experienced radiologists. We look for team members who want to grow and be professionally challenged, while enjoying a rewarding, caring, and friendly environment. We are looking for a Revenue Cycle Interventional Radiology Specialist to join our team. The pay range for this role will depend on experience and qualifications. Schedule: Monday - Friday 8:30am to 5:00pm. Position Summary: Under the direction of the Senior Revenue Cycle Manager, provide assistance to IR office and hospital staff on carrier Medical Policies, authorizing surgical procedures and denial follow-up. Timely work of all requests for additional information from billing company to expedite IR claim submission and denial follow up. Perform reconciliation of weekly procedures performed at the hospital(s) and offices to ensure all charges are captured for claim submission.

Requirements

Deep understanding of surgical billing and claim follow-up with understanding of insurance carrier claim processing, rules and regulations to include payment, denial and appeal processes, authorization requirements and guidelines.
Deep knowledgeable in anatomy, cardiovascular systems, IR procedures and medical terminology.
Ability to multi-task yet remain focused.
Proficient with automated radiology information systems including billing components.
Ability to handle escalated patient issues
Current CPC and/or RCC or RCCIR certification.
High school diploma or general education degree (GED)
5+ years’ experience in healthcare billing/collections, preferably radiology or surgical or a combination of education and experience.

Nice To Haves

Bi-Lingual helpful though not required.
Strong communication skills

Responsibilities

Follow office and hospital IR procedures revenue cycle process from request to schedule to billed claim resolution, ensuring correct billing practices following carrier guidelines.
Review/resolve billing company’s ‘request for additional information’ (RAI’s)
CPT/ICD-10 review and/or confirmation prior to billing
Coding denials; review for resolution/resubmission and/or adjustment
Addendum requests to provider
Authorization denials: review/for proper resubmission
Assist Senior Revenue Cycle Manager, with IR education on complying with CPT, ICD-10, and carrier guidelines/policies. Educate IR staff as needed on insurance guidelines and billing criteria of surgical procedures performed
Review of account receivable denials, categorize & work with billing company as applicable towards successful claim resolution
Monthly review of current outstanding A/R report
Provide assistance in identifying denial patterns/coding issues
Identify claims mishandled with Senior Manager for educational review and improvement with internal staff and/or billing company
Review insurance carrier, State and federal resources (publications/websites) for administrative and/or medical policy changes and updates. Summarize monthly and review with manager and physicians for staff education when applicable
IR Monthly charge reconciliation in EMR
Assistance with other Revenue Cycle Departments, as needed
Prepare reports and analysis of IR service line performance for all interested parties
Accountable for accurate and complete payment optimization
Sustain denial rate below company defined thresholds of performed procedures
Other revenue cycle responsibilities as needed