Senior Revenue Cycle Specialist

IVX Health

6h•$26 - $28•Remote

About The Position

The Senior Revenue Cycle Specialist heavily interfaces directly with IVX Health administrative and clinical staff, payer representatives, referring providers, and patients daily to review delivered services and to ensure complete and accurate information is documented. This role is primarily responsible for managing the full lifecycle of the revenue cycle as required by all payers. The Senior Revenue Cycle Specialist is a customer service role meant to serve as a resource to those stakeholders who are directly involved in patient care. The ability to multitask in multiple business office/practice management systems and offer exceptional customer service is the foundation of this role. This position is considered fully remote, offering a great work/life balance. A typical schedule is Monday - Friday, during regular business hours. No weekends required!

Requirements

Proficiency with standard office software applications (Microsoft Office, Outlook, Teams, etc.)
Excellent organizational, consultative, analytical, and problem-solving skills
Ability to work independently under general supervision and effectively prioritize workload
Ability to multitask and adapt to fast-paced work environment
Takes initiative and capitalizes on all opportunities to improve department efficiency and effectiveness
Strong interpersonal skills and ability to adjust communication style to match audience
Ability to collaborate and communicate at all levels of an organization
Knowledge of basic medical terminology
High School Diploma or GED required
5-7 years’ experience working in full revenue cycle in a facility or physician office setting or similar role

Nice To Haves

2 Year / Associates Degree in Medical Office Managing, Medical Insurance, or Medical Coding strongly preferred
Certified Professional Coder or Certified Professional Biller is a plus

Responsibilities

Engage daily with market leaders to obtain assistance with denials that require local assistance.
Review and answer escalated emails from all IVX markets
Facilitate review and submission of escalated appeals from Billing Manager or Follow-Up Team as needed
Support Billing Managers by training new colleagues on follow-up processes to ensure proficiency in all required functions
Review and obtain any additional clinical information (including but not limited to medical history, support for diagnosis, and letters of medical necessity) required to complete payer appeals
Diligently review underpayment reports and collaborate with Billing team members to resolve
Lead overpayment report review and refund submission to Accounting
Communicate with insurance companies to resolve denials and obtain payment
Work with Billing Manager to establish follow-up in new markets prior to handing over to assigned follow-up team member
Facilitate collaboration calls with Prior Authorization, Contracting and Credentialing teams as needed to identify trends and resolve denials
Investigate outstanding unpaid claims reports to include making sure new payers are set up for RTE, ERA and EFT with clearinghouse
Assist with any denied claims needing Prior Authorization team intervention
Assist with payer policy review for team members working on denials
Assist Billing Manager with QA of payment posting, insurance/patient follow-up, coding, and financial counseling teams
Demonstrate excellent customer service skills through patient-centered communications
Contribute to departmental continuous improvement by recommending process improvements
Take ownership of special projects, research data and follow through with detailed action plans as assigned by your manager
Actively participate in problem identification and coordinates resolution between appropriate parties
Perform duties and job functions in accordance with the policies and procedures established for the department.

Benefits

401(k) Retirement Plan with Company Match
Medical, Dental, and Vision Coverage
Prescription Drug Coverage and Telemedicine Services
Health Savings Account (HSA), Health Reimbursement Arrangement (HRA), and Flexible Spending Options
Life, AD&D, and Disability Insurance
Accident, Critical Illness, and Hospital Indemnity Coverage
Fertility and Family Planning Support
Tuition Reimbursement and Certification Assistance
Continuing Education and Professional Development Resources
Employee Assistance Program and Wellness Support
Paid Time Off
Volunteer Time Off and Charitable Giving Match
Employee Referral Bonus Program