Revenue Cycle Specialist II
About The Position
The Revenue Cycle Specialist II is responsible for performing a variety of complex duties, including working outstanding insurance claims follow–up for no response, unresolved from payors, and/or claim denials. Works facility claims ("Hospital billing"). Maintains A/R at acceptable aging levels by prompt follow-up of unpaid claims and denied claims. Performs all duties in a manner which promotes teamwork and reflects Intermountain mission, vision and values.h Essential Functions Responsible for the accurate and timely submission of claims follow up, reconsideration and appeals, response to denials, and re-bills of insurance claims, and all aspects of insurance follow-up and collections. Submit requested medical information to insurance carrier. Responsible for the analysis and necessary corrections of invoices or accounts and maintaining work queues. Research and resolve a variety of issues relating to posting of payments and charges, insurance denials, secondary billing issues, credit balances, sequencing of charges, and non-payment of claims. Reconcile accounts, research and resolve various issues relating to posting payments and charges, insurance denials, secondary billing issues, sequencing charges, and non-payment of claims. Identify issues and/or trends and provide suggestions for resolution to management, including payer, system or escalated account issues. Maintain basic understanding and knowledge of health insurance plans, policies and procedures. Accurately and thoroughly document the pertinent collection activity performed while meeting/exceeding productivity and quality standards Participate and attend meetings, training seminars and in-services to develop job knowledge.
Requirements
- Microsoft Office
- Computer literacy
- HIPAA regulations
- Communication (oral and written)
- Accountability/ability to work independently
- Contract Interpretation
- Customer Service
- Read and interpret EOB’s (Explanation of Benefits).
- Knowledge of medical billing and collections
- Medical terminology
- High school diploma
- Two (2)+ years of experience in hospital or physician insurance related activities (Billing & Follow-Up)
- Knowledge of revenue and ICD 10 coding practices
Responsibilities
- Responsible for the accurate and timely submission of claims follow up, reconsideration and appeals, response to denials, and re-bills of insurance claims, and all aspects of insurance follow-up and collections.
- Submit requested medical information to insurance carrier.
- Responsible for the analysis and necessary corrections of invoices or accounts and maintaining work queues.
- Research and resolve a variety of issues relating to posting of payments and charges, insurance denials, secondary billing issues, credit balances, sequencing of charges, and non-payment of claims.
- Reconcile accounts, research and resolve various issues relating to posting payments and charges, insurance denials, secondary billing issues, sequencing charges, and non-payment of claims.
- Identify issues and/or trends and provide suggestions for resolution to management, including payer, system or escalated account issues.
- Maintain basic understanding and knowledge of health insurance plans, policies and procedures.
- Accurately and thoroughly document the pertinent collection activity performed while meeting/exceeding productivity and quality standards
- Participate and attend meetings, training seminars and in-services to develop job knowledge.
Benefits
- We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
- Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
Number of Employees
11-50 employees
