Revenue Cycle Management Specialist

Community Care Network Of Va

4h•Remote

About The Position

At Cenevia, we eliminate operational burdens so our healthcare delivery champions can focus on providing high-quality and cost-effective health outcomes. Since 1996, Cenevia has been a trusted support system, training partner and business process expert for health providers, including Federally Qualified Health Centers (FQHC), private practices, hospitals, managed care organizations, and provider networks. Cenevia provides integrated, network-based services and programs to healthcare clients to help them run their businesses better so that they can focus on patient care. This includes the centralized practice management system, help desk, and support infrastructure that Cenevia established in 1999. The Cenevia staff includes experienced health care professionals from the following areas: Quality Improvement Health Information Technology Revenue Cycle Management Health Plan Contracting Credentialing and Enrollment (NCQA-certified) Summary/Objective: The Patient Account Coordinator III is responsible for all billing duties listed below. The position requires coordination with client contact for the daily and monthly revenue cycle management process.

Requirements

Applicant must have two years of experience in insurance reimbursement, account collections, coding and medical terminology.
Candidate should be proficient in using Microsoft Excel and Word.
Must have excellent customer service and communication skills.
High school diploma or equivalent required.

Responsibilities

Progress notes and account review
Patient demographic and insurance updates
Billing related alert creation and deletion
Claims processing (both paper and electronic)
Clearinghouse review and management of rejected claims
Management and follow up of client returned claims
Daily balancing
Payment posting (both manual and electronic)
Collection management
Insurance website navigation and maintenance of log in access
E-status review for provider participation status
Patient statements processing
Refunds, small balance, and bad debt adjustments
Claim denial management
NGS Fiscal Intermediary Shared System resubmission of denied Medicare Part A claims
Submission and follow up of ECW support tickets and CCNV IT support tickets
Provides information to client/team lead on account issues to be discussed with client
Responds to team and client timely and thoroughly
Professional communications to clients and company employees
Patient phone calls and interpretive management services
Continued education and internal training
Special projects as assigned
Accounts Receivable management reports review and follow up
Responsibility to monitor common claim processing and denials and department goals and KPI’s
Reassigns duties in absence in coordination with client/team lead supervisor