Revenue Cycle Specialist I Remote EST

PHOENIX PHYSICAL THERAPY-posted about 3 hours ago
Full-time • Entry Level
Remote • Cranberry Township, PA
1,001-5,000 employees
Resume
Match Score
Upload and Match ResumeTrack Jobs with Teal

The Revenue Cycle Specialist I provides support covering all aspects of insurance billing, claims follow up and collections, including direct contact to the appropriate third-party payers for all unpaid claims including denied claims and those requiring appeal, non-payment, overpayments, and underpayments.

  • Ensures efficient processing of billing claims, insurance follow up, collection activities and denials.
  • Assists in meeting cash collection goals by reviewing, completing, and submitting appropriate documentation based on payer requirements.
  • Conducts research and provides updates and status of collection efforts within the RCM system.
  • Performs billing, follow-up, and collection functions for third parties, resolving issues that impact or delay claims payment.
  • Communicates information and ideas to make system-wide process improvements.
  • Updates data regarding changes and modifications in plan benefits and other contract information relevant to the billing or claims follow up and collection process.
  • Serves as support staff for various departments and external payers by developing positive relationships with managed care organizations and outside agencies, and clinical areas within the organization.
  • Reviews and responds to correspondence and inquiries generated by third party payers.
  • Provides medical record copies and other pertinent information to the appropriate sources throughout the billing and collection process.
  • Works collaboratively to facilitate the insurance billing and collections process to improve overall cash collection.
  • Professionally answer incoming telephone calls from Payers and patients providing answers to questions and concerns about billing statements.
  • Return all unanswered calls within 24 hours of receipt.
  • Handle all correspondence within 1 week of receipt.
  • Work exception and rejection work queues, review EOBs for correct contract payment.
  • Supports overall Revenue Cycle processes to achieve established targets and goals, including the completion of special/specific assigned projects or tasks.
  • Monitors the status of denials, appeals, and claim errors by using folders/work queues and conducting routine, periodic follow up on previously researched claims items.
  • Monitors, reviews, and suggests revisions or updates to existing forms, documents, and processes required to facilitate timely billing and collections.
  • Prepare and sends written appeals when necessary with appropriate documentation.
  • Ensures completeness of claims by following national, local, and internal billing requirements promoting prompt and accurate submission and payment.
  • Maintains awareness of current regulations.
  • Initiates practices that support current regulations.
  • Performs other duties as assigned or required.
  • High School Diploma or equivalent; post-secondary education a plus.
  • Minimum of 2 years of healthcare related experience in billing and collections or a medical billing certificate.
  • Knowledge with CMS 1500 and UB04 Billing Forms, EOBs, claims, coding, and charges is required.
  • Demonstrated knowledge of third-party and insurance companies’ operating procedures, regulations, and billing requirements, i.e., Commercial, Medicare, Medicaid, etc.
  • Insurance eligibility and benefit verification.
  • Ability to read and understand the information provided on EOB’s, remittance advices, and other insurance correspondence.
  • Excellent verbal and written communication skills
  • Effective customer service skills with the ability to interact with both internal and external customers, i.e., patients, insurance payors, Patient Care Coordinators, and therapists in a professional manner.
  • Ability to prioritize work, handling daily and multiple tasks to completion within the time allotted, while working as part of a team within a demanding environment.
  • Proficiency with Microsoft Office tools with a sharp technical aptitude.
  • Ability to work independently with minimal supervision.
  • Knowledge of physical therapy billing preferred.
  • Knowledge of medical terminology and ICD-10 beneficial.
Track Jobs with Teal

Job Search Resources

•
Resume Builder
•
Resume Examples
•
Cover Letter Examples

Tools

Career Hubs

Guides

Company

© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service