The Revenue Cycle Specialist III is a position that calculates and posts receipts to appropriate accounts, verifies details of transactions; performs billing, posting and collection of claims related to specific payers. In this role, you will report to the Account Receivable Manager, RCM.
Duties/Responsibilities:
Monitor held billing and coordinate resolution of related issues to ensure timely claim submission
Review, research, and correct claims that fail payer edits; update payer information and resubmit claims within the EMR system as needed
Understand and actively follow up on outstanding accounts receivable to minimize aging
Work all assigned and denied claims promptly and accurately
Assist in preparing and submitting appeals and reconsiderations to payers
Collaborate with internal teams (billing, authorizations, clinical, etc.) to resolve billing and collections issues
Communicate with payers to obtain claim status and resolve outstanding balances
Maintain accurate documentation of collection activities and provide updates and reports on collection efforts as requested
Assist with special projects, audits, or process improvement initiatives as assigned
Identifies trends related to denials/coding and delinquent claims and communicate effectively with client manager for feedback to the client
Identifies system/payer issues such as rates, codes, set up and coordinate accordingly
Reports status of accounts and issues to appropriate supervisors and departments – always maintains full transparency of accounts
Follows requirements through the full cycle until accounts are satisfied, including patient collections and appeals
Handles critical accounts and projects, coordinating with management, operations, and payers to ensure issues are resolved
Documents, processes and coordinates all write offs and adjustments as needed
Works with contracting team and management to resolve payer issues
Works with branches for all questions on accounts
Attends regular meetings with teams and management to ensure open communication
Ongoing training and mentorship with team
Assists in AR meetings with management, branches and staff as required
Perform other duties as assigned
Required Skills/Abilities/Knowledge:
Excellent verbal and written communication skills with ability to communicate across all levels of authority within company
Excellent organization, problem solving, and attention to detail
Proven track record of successful collections
Participate with management on process improvements
Train and support team members as assigned
Able to effectively deal with change
Demonstrate ability to troubleshoot EMR and Payor issues
Able to complete projects within specific timetables
Able to successfully interact with people in face to face situations as well as by telephone in a professional and effective manner
Satisfactory background screens as required by State, Federal and Company policy free of any OIG sanctions
Education/Experience/Licenses/Certifications:
Graduate of accredited high school or GED required
Minimum of three years of experience in health-related accounts receivable and collections
Minimum of one year in a leadership role
Physical Requirements:
“You are not required to disclose information about physical or mental limitations that you believe will not interfere with your ability to do the job. However, you should disclose any physical or mental impairment for which special arrangements or accommodations are needed to enable you to perform the essential functions of the job. Your description of any impairment and suggestions for reasonable accommodations will be considered in providing reasonable accommodations.”
Requires the ability to write, dictate or use a keyboard to communicate directives
Utilizes proper body mechanics in multiple environments
Requires the ability to function in multiple environments
FLSA Status: Non-Exempt
EEO Status: Administrative Support Workers
Medical, Dental, and Vision Insurance
Paid Time Off and Paid Sick Time
401(k)
Referral Program
Pay Range: $18.00 - $24.00 / hour
Team Select Home Care reserves the right to change the above job description and qualifications without notice. Team Select Home Care will not discriminate against you on the basis of race, color, religion, national origin, sex, sexual preference, disability, political belief, veteran status, age, or any other status protected by law. Team Select Home Care is an employment-at-will employer.
Top Skills
What We Do
Compassionate long-term adult and pediatric private duty nursing, personal care services, and family caregiving programs from the comfort of home. We're driven by a heartfelt mission to provide personalized and professional home care services that enhance the quality of life for individuals and families.
