Revenue Cycle Specialist
Northeast OB/GYN Associates
Job Posting
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:
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:
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.
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