Revenue Specialist I

Southeast Health • Andover, MA

2d • Onsite

About The Position

Performs daily activities involved in the reimbursement process, i.e., claims filing/follow-up, entry of payments/adjustments, follow-up on non-payment or payments below contracted fee schedule amount. Identifies any repetitive errors, either system/manual so that corrective action may be taken and documented. Performs all tasks in a timely manner to ensure consistency in Accounts Receivables totals and maintain a minimum of days in A/R.

Requirements

• High School diploma
• Working knowledge of CPT and ICD 10 coding systems
• Working knowledge of computers
• Basic keyboard/typing skills
• Basic computer skills
• Calculator skills

Nice To Haves

• One year of revenue cycle experience preferred
• Coding Certification preferred

Responsibilities

• Works as part of a multi-disciplinary team to provide answers to inquiries and questions
• Troubleshoot problems and provide information
• Handle intervention or referrals with a professional and respectful customer service focus telephonically and/or in person
• Provides a variety of support services in connection to the day-to-day operations in a health care environment
• Maintains working knowledge of regulatory guidelines for billing
• Provides claim submission for services provided at SEH
• Provides follow up on claims which did not process correctly
• Provides follow up with insurance companies or individuals to obtain accurate reimbursement
• Reviews correspondence daily for appropriate follow up
• Works closely with clinical team for accurate charges and modifiers
• Verifies third party payer coverage
• Coordinates authorizations when appropriate
• Works closely with coding team for accurate submission on claim
• Process and follow up on payer denials, consulting with various entities for completion
• Research and resolve client billing problems or issues
• Provide communication on the methods and principles used for billing to the customers and resolve concerns
• Study contractual terms and conditions of payment to ensure payments are made consistent with terms
• Conduct work functions to assist with late charge processes
• Works closely with third party collection vendors for accurate payment records
• Assist patients and their families with applying for financial assistance
• Establish payroll deduction transactions
• Make daily deposits to the bank
• Ensure change fill requests are complete for department’s daily function
• Work with patients to develop self-pay arrangements and payment plans when applicable
• Post payments for both insurance and individuals
• Review accounts and initiate refunds when applicable
• Communicate self-pay balances for upcoming services and collect balances due
• Work with accounting department for accurate financial documentation
• Edit account for correct coverage documentation
• Apply contractual adjustments in accordance with contracts
• Print, scan and index correspondence to the appropriate account
• Works closely with electronic payment process vendor for accurate posting and adjustments electronically
• Oversee the electronic flow of the account through the billing process to include bad debt
• Performs all other duties as assigned

What This Job Offers

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