Revenue Cycle Specialist I Hospital Billing and Collection | Support Center | Days

Work Status Details: REGULAR FULL TIME | 80 Hours Every Two Weeks Shift: Days Pay Rate Type: Hourly Location: Support Center Salary range: Min $17.67, Mid $21.64, Max $25.98 (actual salaries may vary based on skills and experience). Summary The Revenue Cycle Specialist I, under the direction of the Supervisor, performs all billing and collection activities for all inpatient, outpatient, emergency and professional services provided by Onvida Health. The specific job duties are comprised of a combination of responsibilities from among the various areas of Revenue Cycle operations including third party insurance billing and collections, payer denial review and appeals processing, payment applications, credit balance review and resolution, self-pay billing and collections, financial assistance and bad debt applications. The position requires a background in hospital and/or professional accounts receivable and working knowledge of reimbursement requirements of healthcare payers. Responsibilities Hospital and Professional Billers: perform initial billing on third party claims, either electronically or paper. Reviews and corrects all billable claims in billing software in accordance with payer-specific guidelines and billing requirements. Prepares and submits appropriate billing attachments as required by specific payors. Comply with all government and third-party payers regulatory mandated requirements for billing and collections. Hospital and Professional Insurance Collectors: perform timely and appropriate follow-up on unpaid, underpaid, suspended, and denied accounts, utilizing system work queues and/or reports, payer portals, etc. Performs outgoing calls to patients and insurance companies to obtain necessary information for accurate billing, collections and correction of denials. Prepare appeal letters, with appropriate supporting documentation to insurance carriers when not in agreement with claim denial. Reviews remittance advice to ensure payments are correct for services rendered and resolve payment discrepancies. Reviews credit balance accounts and take appropriate action to resolve the credit balance. Single Billing Office (SBO) Self Pay Collectors: handle self-pay accounts, including financial assistance and collection agency assignment. Provides exemplary customer service to ensure that patients come first. Answers incoming patient phone calls and make outbound collection calls on open balances. Works with patients to set up appropriate payment plans on their accounts when applicable and follows up on past due payment plans. Identifies patients with potential financial hardship and qualifies for Financial Assistance (with all appropriate documentation). Responsible for appropriate handling of bankruptcy and deceased accounts. Enterprise Billing (EB) Payment Posters: apply insurance payments, either electronically or from paper Explanation of Benefits (EOBs) against the appropriate account or line-item service and enters the adjustments, denial codes, copays, deductibles and co-insurance as indicated. Processes transactions in system by effectively and efficiently handling patient cash, check and credit card payments; to include daily posting of lockbox and patient electronic payment files, daily balancing and reconciliation of cash collected and prepare daily bank deposits, as appropriate. Handles the cash clearing and PLB accounts, undistributed payments, credit balancing activities along with determining and investigating unidentified accounts and processing refunds for patients and insurance companies. Organizes work and accomplishes results; prioritizes individual and departmental workload; handles multiple tasks simultaneously; follows up on assignments and meets deadlines. Maintains productivity and accuracy necessary to meet monthly collection goals. Models core values consistently. Sets an example with behavior and attitude that exemplifies an eagerness to satisfy, develop positive relationships with clients, patients, co-workers, payers, and enhance public relations through verbal communication. Projects a mature problem‑solving attitude while dealing with interpersonal conflict. Contributes to team‑building efforts within the department; interacts, communicates, and collaborates with team members to maximize group effectiveness; is a mentor and assists in training of fellow team members; addresses issues and concerns directly with coworkers to promote mutual respect within the work unit; contributes individually and/or through teams to the ongoing improvement of work processes. Other duties as assigned. Requirements Minimum Education: High School Diploma or Equivalent. 1+ year experience in a Healthcare setting. Preferred Experience Working knowledge of self‑pay or insurance billing and collections, and insurance terminology Working knowledge of UB04, CMS 1500 and Explanation of Benefits (EOB) interpretation Working knowledge of CPT, ICD‑10, HCPCS, and modifiers Working knowledge of medical reimbursement policies and procedures Epic EHR experience Physical Requirements and working conditions for this position will be provided to you up on interview. #J-18808-Ljbffr Onvida Health