Specialist, Revenue Cycle

CareSpot • Jacksonville, FL

20h

About The Position

The Revenue Cycle Specialist will be responsible for the day-to-day operation in the following areas: billing, Claims resolution, A/R follow-up, Credit Balance, EDI Billing, or Posting. Under the direction of the Manager the specialist will be responsible for handling all functions related to the designated area and any other duties assigned by management.

Requirements

• 2+ years of relevant Workers Compensation billing experience within a healthcare facility or healthcare insurance company.
• Deep understanding of medical billing rules and supporting documentation requirements for Workers Compensation payors.
• Knowledge of ICD-10 and HCPC coding, modifiers, and other medical terminology.
• Proficient with Microsoft Office, specifically Excel, Outlook, and Word.
• High School diploma required.
• Ability to pass a Level II background screening and clearance through AHCA (Agency for Healthcare Administration) - https://info.flclearinghouse.com/

Nice To Haves

• NextGen experience a plus, but not a requirement.

Responsibilities

• Responsible for claim submissions to Workers Compensation payors in accordance with all insurance regulations and requirements.
• Process Urgent Care Payor credit card payments.
• Provide all necessary documentation required by payors to resolve claim issues or denials, including medical records, prior authorizations, audits, etc.
• Analyze and research all denials and over or under payments.
• Ensure all payor correspondence is reviewed and followed up on immediately.
• Provide exceptional customer service and communication to employers/payors and resolve any accounts receivable requests in a timely and accurate manner.
• Communicate any issues to the Revenue Cycle Director.
• Other duties and responsibilities as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees