Revenue Cycle Resolution Specialist

Job Function:

Resolution of all unresolved Portal and EDI assigned accounts receivable. Increase cash collection, ensuring all claims are submitted and/or resubmitted within the initial and total filing limit. Processing appeals as needed. Keeping open communication, troubleshoot and resolve open balances while managing a healthy relationship with our Clients and Payers.

Responsibilities:

• Ensure all accounts with accounts receivables over 60 days have a pending resolution and/or resolution before claims reach the 180-day transactional RCM system date and/or filing limit
• Follow up on all assigned Rejected claims within the RCM Clearing house
• Understand and perform research of all historical data with accounts assigned to you 
  1. Make any adjustments, resubmittals, appeals and/or credits on claims for any given Client and/or Payer 
  2. Being confident to act when speaking to an account within Leadership guidelines to resolve past due balances and/or issues
  3. Ensure all unapplied payments/credits on accounts are posted correctly prior to closing of Month End
  4. Process Payer Changes and/or terminations within the Retention process
• Assist with processing credit card and direct debit charges as needed
• Communicate in a highly professional manner and nurture a healthy relationship with Clients and/or Payer accounts
• Generate weekly reports to Leadership on collection activity, claim statuses such as payments, resubmitted claims, appeals, credits, and escalations needed etc.
• Working as a Team member, assisting others as needed 

Position Requirements:

• 6 months of billing, finance, or accounting experience (insurance preferred)
• 1 year of college coursework or equivalent work experience
• Exceptional organizational and time management / prioritization skills
• Skilled at problem solving 
• Skilled at verbal and written communication, including knowledge of email etiquette
• Basic knowledge of billing concepts such as reconciliation, posting, deposits, debits, and    

credits

• Demonstrated attention to detail
• Willingness to work as part of a collaborative team, but also independently accomplish tasks
• Understand HIPAA and privacy regulations

Demonstrate ethical business practices