RCM Specialist Collections
KPH HEALTHCARE SERVICES, INC
- Manage the collection process for outstanding claims, including contacting insurance companies, patients, and other responsible parties via phone, email, and written correspondence.
- Investigate and resolve denied or partially paid claims, identifying root causes and implementing corrective actions.
- Collaborate with internal teams to address claims challenges and improve revenue cycle.
- Escalate complex or uncollectible accounts to management for further action.
- Submit appeals/claim corrections as needed within timely filing limits.
- Utilize billing software to maintain accurate and detailed records of all collection activities, including communication with payers and patients.
- Payer projects as assigned.
- Identify and report trends in claim denials and payment challenges.
- Communicate as needed with patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries about billing.
- Support accurate and comprehensive record-keeping to ensure up-to-date information is maintained and effectively shared across departments.
- Assist in the implementation of processes to measure, assess, and improve the performance of the RCM department activities of the company.
- Ensure ongoing compliance with all laws and regulations; ensure that the department meets or exceeds accreditation standards; and implement "best practices" in all departmental activities.
- Participate in surveys conducted by authorized inspection agencies.
- Participate in the company's Performance Improvement program as requested by the Performance Improvement Coordinator.
- Participate in company committees when requested.
- Participate in in-service education programs provided by the company.
- Pursue continuing education programs appropriate to job responsibilities.
- Perform other duties as assigned by supervisor.
- Complete all mandatory and regulatory training programs.
- Report any misconduct, suspicious or unethical activities to the Compliance Officer.
- Complies with accepted professional standards and practice.
Vacancy posted 22 hours ago
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