RCM Billing & Collections Specialist

Commercial Claims Processor

The primary purpose of this position is to create claims invoices to third party insurance carriers for commercial products and to monitor aging to ensure proper and timely payment.

• Responsible for correcting claim data in Acuity Logic system prior to billing for specified plans
• Responsible for submitting both paper and electronic claims in Acuity Logic for specified plans to third party carriers timely
• Responsible for submitting manual vouchers and invoices to plans that don't accept claim forms in a timely manner
• Maintain and report personal KPI data to Manager on a weekly basis
• Responsible for interpreting and following up on claim denials from third party carriers for specified plans
• Responsible for monitoring the aging of specified plans to ensure prompt and accurate payment for specified plans
• Develops expertise in specific plans assigned to the position and acts as a department and company resource for questions relating to billing of these plans
• Assist AR Manager and Commercial Claim Supervisor on special projects as needed.
• Communicates all system, site, and billing company issues to the AR Manager on a timely basis to allow management oversight and proper resource planning
• Be a resource for retail units for questions relating to billing
• Makes recommendations for efficiencies, processes, etc. which will deliver quality, cost savings, and/or profitability improvements within the department and/or across the organization

• High school diploma or GED or equivalent
• 1 year AR experience with third party billing
• Knowledge of insurance billing processes
• Entry level PC skills in MS Windows, Word and Excel
• Effective verbal and written communication skills to effectively speak with coworkers, and prepare concise and accurate reports
• Demonstrated ability to work successfully in a team environment, functioning for the good of the team over the individual

Benefits

• 401(k) with Match
• Medical/Dental/Life/STD/LTD
• Vision Service Plan
• Employee Vision Discount Program
• HSA/FSA
• PTO
• Paid Holidays

*Benefits applicable to full Time Employees only.

Physical Demands

• This position requires the ability to communicate and exchange information, utilize equipment necessary to perform the job, and move about the office.