Revenue Cycle Specialist

Medical Accounts Receivable Specialist Position Summary

The Medical Accounts Receivable Specialist is responsible for overall revenue cycle functions. The Medical Accounts Receivable Specialist helps improve cash flow and participates in increasing the overall health of the company's receivables.


Relationships and Contacts

Within the organization: Maintains close and frequent contact with the finance and revenue cycle team members within Odyssey and other locations as assigned.


Outside the organization : Maintains close and frequent contact with insurance providers and third-party vendors, as necessary.

Position Responsibilities

Essential Responsibilities

1. Performs timely follow up on aging AR.
2. Researches and resolves rejected, incorrectly paid, and denied 837 claims.
3. Keeps accurate and detailed updates in the billing software of all claims' statuses.
4. Understands and consistently applies thorough understanding of all insurance plans.
5. Understands and interprets insurance Explanation of Benefits, knowing when and how to ensure that payment has been received.
6. Skillfully and professionally navigates phone calls with insurance companies and websites to effectively reprocess unpaid or incorrectly paid claims.
7. Understands authorizations and limits to coverage such as the number of authorizations/units.
8. Responds in a professional and timely manner to all billing-related inquiries from patients, staff and payers.
9. Completes complex billing functions, such as creating corrected claims, creating voided claims, secondary billing, and appeals.
10. Reviews patient bills for accuracy and completeness and obtain any missing information.
11. Consolidates and sends all requested medical documentation to insurance companies to ensure timely review and adjudication.
12. Provides excellent customer service with the ability to communicate to both insurance companies as well as families in the efforts of collecting outstanding balances.
13. Performs month end account review for remainder billing, Room & Board charges, and unapplied balances.

Additional Responsibilities

1. Documents billing and collection activities and communicates to supervisor as appropriate.
2. Prepares reports and reconciliations as needed.
3. Completes daily, weekly, and monthly assignments as assigned by Supervisor.
4. Maintains a strict level of confidentiality for all company, departmental, and healthcare provider information.
5. Functions within the guidelines of the facility's Code of Ethics and in accordance with corporate compliance.
6. Updates job knowledge by participating in educational opportunities; reading professional publications related to the Odyssey Eating Disorder Network and population.
7. Provides a high level of customer service to both internal and external stakeholders.
8. Performs other related duties as assigned.

Minimum Requirements

Education and Experience

High school diploma or equivalent and at least two (2) years of healthcare insurance accounts receivable experience required. Prior experience in Mental Health, Substance Abuse Disorder Treatment or behavioral healthcare field preferred.

Physical Requirements

• While performing the duties of this job, the employee will be required to communicate with peers, clients and/or vendors.
• Job performance will require the ability to move throughout the building.
• Performs duties that require the employee to stand and walk for extended periods of time.
• May sit or remain stationary for periods of time.
• While performing the duties of this job, the employee may be required to talk or hear, sit, stand, walk, reach, climb or balance, stoop, kneel, crouch or crawl, taste or smell
• Ability to move up to 25 pounds

Skill Competencies

• Demonstrates strong computer and communication skills.
• Demonstrates a high level of customer service.
• Demonstrates a high level of attention to detail and organizational and prioritizing skills.
• Demonstrates proficiency in Microsoft Office Suite.
• Welcomes and integrates feedback from team/leadership.
• Possesses a clear understanding of safety and security standards of Odysseys Eating Disorder Network and the employee's role within those standards.
• Demonstrates strong problem solving and analytical skills and the ability to use sound judgement.
• Demonstrates excellent verbal and written communication skills, while building and maintaining professional relationships.
• Demonstrates commitment to the mission, vision, values, and treatment philosophy of Odyssey Behavioral Healthcare.

ISJP123

Odyssey Behavioral Healthcare, LLC provides equal employment opportunities without regard to race, color, creed, ancestry, national origin, ethnicity, sex, gender, sexual orientation, marital status, religion, age, disability, gender identity, genetic information, service in the military, or any other characteristic protected under applicable federal, state, or local law. Equal employment opportunity applies to all terms and conditions of employment. Odyssey Behavioral Healthcare, LLC reserves the right to modify, interpret, or apply this job description in any way the organization desires. This job description in no way implies that these are the only duties, including essential duties, to be performed by the employee occupying this position. Reasonable accommodations may be made to reasonably accommodate qualified individuals with disabilities. This job description is not an employment contract, implied or otherwise. The employment relationship remains "At-Will."