Revenue Cycle Specialist I

Southeast Health•Dothan, AL

About The Position

Performs daily activities involved in the reimbursement process, i.e., claims filing/follow-up, entry of payments/adjustments, follow-up on non-payment or payments below contracted fee schedule amount. Identifies any repetitive errors, either system/manual so that corrective action may be taken and documented. Performs all tasks in a timely manner to ensure consistency in Accounts Receivables totals and maintain a minimum of days in A/R.

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/typing skills
Basic computer skills
Calculator skills

Nice To Haves

One year of revenue cycle experience preferred
Coding Certification preferred

Responsibilities

Works as part of a multi-disciplinary team to provide answers to inquiries and questions
Troubleshoot problems and provide information
Handle intervention or referrals with a professional and respectful customer service focus telephonically and/or in person
Provides a variety of support services in connection to the day-to-day operations in a health care environment
Maintains working knowledge of regulatory guidelines for billing
Provides claim submission for services provided at SEH
Provides follow up on claims which did not process correctly
Provides follow up with insurance companies or individuals to obtain accurate reimbursement
Reviews correspondence daily for appropriate follow up
Works closely with clinical team for accurate charges and modifiers
Verifies third party payer coverage
Coordinates authorizations when appropriate
Works closely with coding team for accurate submission on claim
Process and follow up on payer denials, consulting with various entities for completion
Research and resolve client billing problems or issues
Provide communication on the methods and principles used for billing to the customers and resolve concerns
Study contractual terms and conditions of payment to ensure payments are made consistent with terms
Conduct work functions to assist with late charge processes
Works closely with third party collection vendors for accurate payment records
Assist patients and their families with applying for financial assistance
Establish payroll deduction transactions
Make daily deposits to the bank
Ensure change fill requests are complete for department’s daily function
Work with patients to develop self-pay arrangements and payment plans when applicable
Post payments for both insurance and individuals
Review accounts and initiate refunds when applicable
Communicate self-pay balances for upcoming services and collect balances due
Work with accounting department for accurate financial documentation
Edit account for correct coverage documentation
Apply contractual adjustments in accordance with contracts
Print, scan and index correspondence to the appropriate account
Works closely with electronic payment process vendor for accurate posting and adjustments electronically
Oversee the electronic flow of the account through the billing process to include bad debt
Performs all other duties as assigned