Special Projects Follow-Up Specialist - Revenue Cycle

ProTransport-1•Cotati, CA

1d•$25

About The Position

Job Summary: Performs day-to-day billing/follow-up activities required to get final resolution and collect outstanding accounts receivables (AR) from patients and insurances. Pay Rate: $25.00/hr, non-exempt Essential Duties and Responsibilities: Processes billing/follow-up functions to increase cash collections and decrease AR (i.e., checks claim status, responds to additional documentation requests, confirms insurance eligibility, updates patient demographics, authorizations, payer, and ICD-10 coding). Identifies claims processing issues and works through them for claims resolution. Expedites and maximizes payment of claims by contacting and following-up with communications to and from payers and patients via phone, online portals, email, fax, and mail. Performs claim negotiations and appeals. Files payor complaints at the local, state, and federal level Processes denials and works down AR. Utilizes all available resources (i.e., explanation of benefits, payer/vendor websites), to ensure claims are adjudicated correctly. Updates billing system to ensure that follow-up actions are properly documented. Completes detailed forms and reports accurately. Meets daily/monthly department goals. Manages changes in priorities based on business need. Ensures compliance with State and Federal guidelines. Requests prior authorizations for state programs and health plans when required by using the payer’s online portal and or required applicable form Possesses knowledge of payer specific guidelines. Works correspondence and other mail from multiple sources i.e., fax, e-mail, and physical mail appropriately and timely. Manages incoming calls and email communications to resolve or direct to appropriate parties for resolution. Effectively communicates with RCM Management and external stakeholders. Performs additional duties as assigned.

Requirements

High school diploma, GED, or equivalent
Two (2) or more years of experience in EMS and/or ambulance revenue cycle follow-up processes
Must be able to read, write, and speak English fluently
Demonstrated excellent documentation skills
Computer literate (i.e. experience working with Microsoft Office Suite and typing skills)
Ability to work with minimal supervision, following guidelines and company policy
Collect, interpret, and analyze complex data

Nice To Haves

Experience working with Medicare, Medicaid and commercial insurances

Responsibilities

Processes billing/follow-up functions to increase cash collections and decrease AR (i.e., checks claim status, responds to additional documentation requests, confirms insurance eligibility, updates patient demographics, authorizations, payer, and ICD-10 coding).
Identifies claims processing issues and works through them for claims resolution.
Expedites and maximizes payment of claims by contacting and following-up with communications to and from payers and patients via phone, online portals, email, fax, and mail.
Performs claim negotiations and appeals.
Files payor complaints at the local, state, and federal level Processes denials and works down AR.
Utilizes all available resources (i.e., explanation of benefits, payer/vendor websites), to ensure claims are adjudicated correctly.
Updates billing system to ensure that follow-up actions are properly documented.
Completes detailed forms and reports accurately.
Meets daily/monthly department goals.
Manages changes in priorities based on business need.
Ensures compliance with State and Federal guidelines.
Requests prior authorizations for state programs and health plans when required by using the payer’s online portal and or required applicable form
Possesses knowledge of payer specific guidelines.
Works correspondence and other mail from multiple sources i.e., fax, e-mail, and physical mail appropriately and timely.
Manages incoming calls and email communications to resolve or direct to appropriate parties for resolution.
Effectively communicates with RCM Management and external stakeholders.
Performs additional duties as assigned.