Revenue Cycle Specialist I

Southeast Health•Dothan, AL

About The Position

Performs daily activities involved in the reimbursement process, including claims filing and follow-up, entry of payments and adjustments, and follow-up on non-payment or payments below contracted fee schedule amounts. Identifies repetitive system or manual errors so corrective action can be taken and documented. Performs tasks in a timely manner to maintain consistency in Accounts Receivable totals and minimize days in A/R. The role supports day-to-day operations in a health care environment and works with customers, patients and families, clinical and coding teams, accounting, insurance companies, and third-party vendors.

Requirements

High school diploma.
Working knowledge of CPT and ICD-10 coding systems.
Working knowledge of computers.
Excellent written, verbal, and interpersonal skills.
Ability to interact with customers in both hospital and clinic environments.
Basic keyboard and typing skills.
Basic computer skills.
Calculator skills.

Nice To Haves

One year of revenue cycle experience.
Coding certification.

Responsibilities

Work as part of a multidisciplinary team to answer inquiries and questions.
Troubleshoot problems and provide information.
Handle interventions or referrals professionally and respectfully, by telephone or in person.
Provide support services for day-to-day operations in a health care environment.
Maintain working knowledge of regulatory billing guidelines.
Submit claims for services provided at SEH and follow up on claims that did not process correctly.
Follow up with insurance companies or individuals to obtain accurate reimbursement.
Review correspondence daily and follow up appropriately.
Work with the clinical team to ensure accurate charges and modifiers.
Verify third-party payer coverage and coordinate authorizations when appropriate.
Work with the coding team to ensure accurate claim submission.
Process and follow up on payer denials, consulting with relevant entities to resolve them.
Research and resolve client billing problems or issues.
Explain billing methods and principles to customers and resolve concerns.
Review contractual payment terms and conditions to ensure payments comply with them.
Assist with late-charge processes.
Work with third-party collection vendors to maintain accurate payment records.
Assist patients and families with applications for financial assistance.
Establish payroll deduction transactions.
Make daily bank deposits and ensure change-fill requests are complete for the department's daily operations.
Work with patients to develop self-pay arrangements and payment plans when applicable.
Post insurance and individual payments.
Review accounts and initiate refunds when applicable.
Communicate self-pay balances for upcoming services and collect balances due.
Work with the accounting department to ensure accurate financial documentation.
Edit accounts to ensure correct coverage documentation.
Apply contractual adjustments in accordance with contracts.
Print, scan, and index correspondence to the appropriate account.
Work with the electronic payment process vendor to ensure accurate electronic posting and adjustments.
Oversee the account's electronic flow through the billing process, including bad debt.
Perform other duties as assigned.