Revenue Cycle Interventional Radiology Specialist

Advanced Radiology Consultants • Shelton, CT

10d

About The Position

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

Benefits

• Medical and Prescription Drug Coverage
• Dental Coverage
• Vision Coverage
• Health Savings Account (HSA)  with Matching Employer Contribution
• Generous Paid Time Off (PTO)
• Paid Holidays
• 401(k) Plan with Employer Contribution
• Annual Profit-Sharing Plan Contribution
• Paid Opt-Out Benefit Option
• Basic Life and Accident Insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED