Revenue Cycle Specialist III, RCM

Team Select Home Care • Miami, FL

120d • $18 - $24

About The Position

The Revenue Cycle Specialist III is a position that calculates and posts receipts to appropriate accounts, verifies details of transactions; performs billing, posting and collection of claims related to specific payers. In this role, you will report to the Account Receivable Manager, RCM.

Requirements

• Excellent verbal and written communication skills with ability to communicate across all levels of authority within company
• Excellent organization, problem solving, and attention to detail
• Proven track record of successful collections
• Participate with management on process improvements
• Train and support team members as assigned
• Able to effectively deal with change
• Demonstrate ability to troubleshoot EMR and Payor issues
• Able to complete projects within specific timetables
• Able to successfully interact with people in face to face situations as well as by telephone in a professional and effective manner
• Satisfactory background screens as required by State, Federal and Company policy free of any OIG sanctions
• Graduate of accredited high school or GED required
• Minimum of three years of experience in health-related accounts receivable and collections
• Minimum of one year in a leadership role
• Requires the ability to write, dictate or use a keyboard to communicate directives
• Utilizes proper body mechanics in multiple environments
• Requires the ability to function in multiple environments

Responsibilities

• Monitor held billing and coordinate resolution of related 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
• Understand and actively follow up on outstanding accounts receivable to minimize aging
• Work all assigned and denied claims promptly and accurately
• Assist in preparing and submitting appeals and reconsiderations to payers
• Collaborate with internal teams (billing, authorizations, clinical, etc.) 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
• Identifies trends related to denials/coding and delinquent claims and communicate effectively with client manager for feedback to the client
• Identifies system/payer issues such as rates, codes, set up and coordinate accordingly
• Reports status of accounts and issues to appropriate supervisors and departments – always maintains full transparency of accounts
• Follows requirements through the full cycle until accounts are satisfied, including patient collections and appeals
• Handles critical accounts and projects, coordinating with management, operations, and payers to ensure issues are resolved
• Documents, processes and coordinates all write offs and adjustments as needed
• Works with contracting team and management to resolve payer issues
• Works with branches for all questions on accounts
• Attends regular meetings with teams and management to ensure open communication
• Ongoing training and mentorship with team
• Assists in AR meetings with management, branches and staff as required
• Perform other duties as assigned

Benefits

• Select Family Medical, Dental, and Vision Insurance
• Paid Time Off and Paid Sick Time
• 401(k)
• Referral Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED