Revenue Cycle Specialist

Revenue Cycle Specialist

Job Category: Buss Office Support Requisition Number: REVEN001506

Full-Time

Northeast OB/GYN | Administrative Building 14100 San Pedro Ave San Antonio, TX 78232, USA

Job Details

Description

Below is a listing of job duties/responsibilities:

• Maintains detailed knowledge of revenue cycle functions.
• Reviews and completes work log tasks in the system by working through claim edits, denials, and aging tasks; turns in daily productivity reports as required.
• Works accounts receivable to ensure timely payments from insurance.
• Initiates claim submissions, performs account review, and ensures work is accurate and complete.
• Identifies trends, conducts follow-up, and performs root cause analysis on unpaid accounts.
• Responds to inquiries and calls from patients or staff members.
• Reviews websites, bulletins, and other resources to maintain current knowledge of regulatory requirements and relays information to Manager and team members.
• Performs insurance eligibility verifications and updates patient coverage as needed.
• Reviews charges for accuracy, completeness, modifiers, and medical necessity; corrects as necessary and submits timely. Corrects and resubmits rejected claims.
• Manages work queues for assigned providers; follows up with third-party payers on unpaid or denied claims via portals, phone, chat, email, and appeals as necessary.
• Documents contact with insurance companies and others using appropriate designated methods.
• Manages and responds to payer requests for information/medical records for claim adjudication.
• Communicates with patients about billing inquiries and discrepancies.
• Works as part of a cohesive team, providing coverage for other team members as needed.
• Performs additional duties as assigned.

Qualifications

Behaviors

Required

Team Player

Works well as a member of a group

Enthusiastic

Shows intense and eager enjoyment and interest

Dedicated

Devoted to a task or purpose with loyalty or integrity

Detail Oriented

Capable of carrying out a given task with all details necessary to get the task done well

Motivations

Required

Self-Starter

Inspired to perform without outside help

Experience

Preferred

2 years:

Revenue cycle/Billing

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Northeast OB/GYN Associates, PA