REVENUE RECOVERY SPECIALIST

MedCentris • Hammond, LA

1d • Onsite

About The Position

Under the direction of the Assistant Director of Revenue Cycle – Revenue Recovery, the Revenue Recovery Specialist is responsible for monitoring billing & claims follow up on all claims and resolutions from participating insurance carriers and working proactively to collect from secondary insurance carriers.

Requirements

• Previous experience with eClinicalWorks.
• Knowledge of insurance Payers, EMR, Claims.
• Demonstrated understanding of medical terminology, Insurance, EMR, & Claims required.
• Knowledge of patient confidentiality and HIPAA regulations.
• Knowledge of CPT, HCPCS, and ICD10 coding required.
• Knowledge of medical billing and collection practices.
• Understands Medicare and Medical Assistance regulations as they apply to job functions.
• Knowledge of working with electronic health records (EHR/EMR) or healthcare related computer systems.
• Establishes and demonstrates competency in accounts receivable systems & associated applications.
• Ability to communicate effectively with insurance carriers, patients, and co-workers.
• Ability to comply with procedural guidelines and instructions and to solicit assistance when situations arise that deviate from the norm.
• Excellent verbal and auditory skills are required for communicating with internal staff and representatives from external departments & agencies.

Responsibilities

• Receive, open, and accurately deposit payments received via mail in accordance with established policies and procedures.
• Prepare, log, and maintain deposit slips and proofs of deposit received from clinics, ensuring completeness and accuracy.
• Follow up with clinics to obtain missing, incomplete, or incorrect documentation required for proper posting and reconciliation.
• Balance and reconcile the Clinic Reconciliation Sheet daily, investigating and resolving discrepancies in a timely manner.
• Process payments related to Medical Records requests in accordance with organizational and regulatory requirements.
• Complete adjustments for Medicaid claims in accordance with Max Allowed reimbursement guidelines and payer policies.
• Provide backfill support for Reception and Mail Processing functions as operational needs require.
• Assist with the printing of secondary claims, primary claims, and supporting medical records as needed to support timely billing and follow-up.
• Maintain compliance with internal controls, payer requirements, and confidentiality standards while performing all duties.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed
• Number of Employees: 101-250 employees