Revenue Cycle Specialist

JOB SUMMARY:

Responsible for online and telephonic insurance verification, both in advance and day of appointments for clients that walk-in with new or updated insurance info.  Assist in the updating of computerized patient information including, but not limited to patient demographic and billing information.

 ESSENTIAL JOB DUTIES AND RESPONSIBILITIES:

1.       Verify eligibility and document verification. Check client account for outstanding balance. Assist client with arrangement for payment. 

2.       Responsible for following billing and collection rules.

3.       Review patient deductible and/or copays and enter information into NextGen, provide front of patient responsibilities. If the patient has additional questions, see the Revenue Cycle Specialist to discuss.

4.       Discuss financial obligations with patient and make necessary arrangements.

5.       Provide answers to patients, clerical staff and insurance companies.

6.       Works in conjunction with billing team on ensuring clean billing.

7.       Navigate provider online portals and systems. 

8.       Meeting individually with clients to determine their financial objectives risk tolerance, income, expenses, assets and referring patient to registration for additional services.

9.       Observe lobby activity to ensure that all patients are waiting in appropriate area and/or have signed into the clinic.

1. Accept job related assignments, training, and development in new tasks and technologies.
2. Comply with all company policies, procedures and regulatory requirements.
3. Performs all other duties as assigned by management.

EDUCATION/LICENSURE/CERTIFICATION QUALIFICATIONS:

1. High school diploma or GED required
2. Medical Office Administration certificate preferred
3. Typing ability required.
4. Bilingual ability in Spanish strongly preferred.

SKILLS AND EXPERIENCE:

1. One year of work experience in a medical setting, or three years of insurance verification experience and financial counseling required.
2. Familiarity with office machines: computer, calculator, fax, and photocopier.
3. Familiarity with accounting principles and insurance billing.
4. Demonstrated helpful, positive attitude.
5. Demonstrated ability to handle difficult staff and patients.
6. High ethical standards.
7. Strong work ethic.
8. Demonstrated ability for multi-tasking.
9. Demonstrated customer service skills
10. Demonstrated problem solving skills
11. Detail oriented.
12. Team player.
13. Ability to work with people of all socioeconomic levels.
14. Consumer advocate for quality health care and services.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle and feel objects, tools and controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch and crawl; talk and hear; taste and smell. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

WORK ENVIRONMENT:

Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is not exposed to weather conditions. The noise level in the work environment is usually moderate.

Hours:

Employees will be assigned to a regular work schedule, which may include hours between 7:00am and 7:00 pm and weekends as determined by department needs and requirements.