Revenue Cycle Specialist (1950)

US Heart & Vascular

4d • Onsite

About The Position

US Heart and Vascular is in need of a Revenue Cycle Specialist to join our team at Samuel Family Cardiology in Spring, TX Responsibilities:

Requirements

• Proficient in medical terminology, anatomy, and physiology
• Strong knowledge of ICD-10 coding
• Familiarity with medical office procedures and billing practices
• Flexible, Detail Oriented, Customer focus, Team working, Initiative, Problem solving, Organized, Self-motivated
• Computer skills – good working knowledge of MS office
• Ability to communicate effectively with others, both verbally and in writing
• Proven ability to manage time, meet deadlines and prioritize
• High School Diploma or equivalent required
• Knowledge of the accounts receivables (A/R) process
• At least four (4) years’ healthcare or insurance billing processing experience required
• Knowledge of medical terminology, CPT, ICD-10-CM, HCPC codes, CCI edits and HIPAA regulations

Nice To Haves

• Bachelor's Degree in a related field preferred
• eClinicalWorks experience a plus

Responsibilities

• Responsible for billing all patient claims in a timely manner
• Perform extensive claims follow up activities, utilizing the current Practice management (PM), and clearinghouse systems.
• Investigate, analyze, and resolve problematic and delinquent insurance claims.
• Work daily claims rejection lists including but not limited to, eligibility, coordination of benefits, clearinghouse smart edits, etc.
• Responsible for appeals management – 1st, 2nd and ADJ level appeals as well as peer-to-peer reviews.
• Utilize clinical applications, payer websites and other systems as a research tool to retrieve medical documentation, patient eligibility information, billing guidelines, patient referrals, and hospital or procedure code authorizations to substantiate corrected claims submissions, through written appeals, and coding reviews, etc.
• Establish and maintain effective working relationships with carrier representatives and internal and external clients.
• Collaborate with physicians and billing team to resolve coding and billing discrepancies
• Remain abreast of carrier/payer updates as it relates to Billing and Collections guidelines including claim submissions, claim appeals, grievance procedures and policy changes.
• Responsible for compliance with all regulatory requirements and/or guidelines. These requirements/guidelines include, but are not limited to: OSHA, HIPAA, Federal Fraud and Abuse laws.

What This Job Offers

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