Revenue Cycle Specialist II, RCM

Team Select Home Care•Phoenix, AZ

1d•$17 - $24

About The Position

The Revenue Cycle Specialist II calculates and posts receipts to appropriate accounts, verifies transaction details, and performs billing, posting, and collection of claims related to specific payers. The position reports to the Accounts Receivable Manager, RCM. The role monitors held billing, researches and corrects claims, follows up on accounts receivable, works denied claims, and assists with appeals and reconsiderations. It collaborates with internal teams, payers, branches, the contracting team, and management to resolve billing and collection issues. The specialist maintains accurate documentation and communicates account status, trends, and issues to appropriate parties. The position also supports special projects, audits, and process improvement initiatives, and performs other duties as assigned. The role requires the ability to write, dictate, or use a keyboard to communicate directives, use proper body mechanics in multiple environments, and function in multiple environments. Applicants must meet background-screening requirements under applicable state, federal, and company policy and be free of OIG sanctions.

Requirements

Graduate of an accredited high school or GED required.
Minimum of two years of experience in health-related accounts receivable and collections.
Excellent verbal, written, and computer communication skills.
Ability to communicate across all levels of authority within the company.
Excellent organization, problem-solving, and project/time management skills.
Ability to work with multiple teams to promote viable, ethical, and cost-effective solutions.
Proven track record of successful collections.
Ability to effectively deal with change.
Ability to complete projects within specific timetables.
Ability to interact professionally and effectively in face-to-face situations and by telephone.
Satisfactory background screens as required by State, Federal, and Company policy, free of any OIG sanctions.
Ability to write, dictate, or use a keyboard to communicate directives.
Ability to use proper body mechanics and function in multiple environments.

Responsibilities

Monitor held billing and coordinate resolution of issues to ensure timely claim submission.
Review, research, and correct claims that fail payer edits; update payer information and resubmit claims within the EMR system as needed.
Follow up on outstanding accounts receivable to minimize aging.
Work assigned and denied claims promptly and accurately.
Assist with preparing and submitting appeals and reconsiderations to payers.
Collaborate with internal teams, including billing, authorizations, and clinical teams, to resolve billing and collections issues.
Communicate with payers to obtain claim status and resolve outstanding balances.
Maintain accurate documentation of collection activities and provide updates and reports on collection efforts as requested.
Assist with special projects, audits, or process improvement initiatives as assigned.
Identify trends related to denials, coding, and delinquent claims and communicate them to the client manager for feedback to the client.
Identify system or payer issues, including rates, codes, and setup, and coordinate accordingly.
Report account status and issues to appropriate supervisors and departments, maintaining transparency of accounts.
Follow requirements through the full cycle until accounts are satisfied, including patient collections and appeals.
Document, process, and coordinate write-offs and adjustments as needed.
Work with the contracting team and management to resolve payer issues.
Work with branches on account questions.
Attend regular meetings with teams and management to ensure open communication.
Perform other duties as assigned.