Revenue Cycle Associate - Healthcare Billing and Claims Specialist

Overview

Are you passionate about making a difference in healthcare? We're looking for a dedicated Revenue Cycle Associate to join our team and help ensure smooth operations within our Revenue Cycle division. In this role, you'll play a crucial part in resolving and reconciling patient account balances, all while working in a collaborative and supportive environment. Your expertise will help us provide excellent service to our internal and external customers.

Key Responsibilities

• Support and Excellence: Perform various support tasks for the Revenue Cycle division, ensuring all processes are carried out efficiently and effectively. Strive to meet or exceed performance metrics and departmental quality standards.
• Collaboration: Work closely with team members and other departments, sharing your expertise to assist with claim verification, submission, and resolution of issues related to payer coverage and payments.
• Problem-Solving: Investigate and resolve complex payment denials, correcting errors and providing additional information as needed to facilitate reimbursement. Use strategic thinking to address and resolve issues efficiently.
• Communication: Maintain professional and effective communication with both internal and external customers. Document all relevant information in patient accounting systems according to established procedures.
• Analysis and Reporting: Provide strategic business analysis and updates to leaders regarding operational opportunities that impact reimbursement. Identify and communicate trends affecting account resolution.
• Technical Proficiency: Utilize your strong knowledge of coding regulations (CPT, HCPCS, ICD-10) and proficiency with various systems and MS Office products. Understand Medicare and Commercial contract language.
• Process Improvement: Support continuous improvement by adapting to process evaluations, managing special projects, and participating in process enhancements.
  
  

Team Responsibilities

• Account Management: Handle collection work queues, including technical denials and at-risk claims. Combine accounts as needed to ensure compliance and resolve aged or problematic accounts.
• Billing Audit: Review accounts for compliance with payer rules, handle unbilled and failed claims, and stay updated on government and non-government regulations for claims submission.
  
  

Requirements

• Education: High School Diploma or equivalent experience required; post-secondary education is preferred.
• Experience: 3-5 years of relevant experience preferred, with a strong background in calculating expected reimbursements, and experience with Commercial, Medicare, and Medicaid reimbursement.
• Skills: Excellent communication skills, proficiency in MS Office, understanding of government programs and billing, and hands-on experience with Medicare Remote (FISS) - DDE is preferred.
  
  

Join Us

If you're ready to make a positive impact and grow within a supportive team environment, we encourage you to apply. Your expertise will be valued, and you’ll have opportunities for professional development as you contribute to our mission of delivering exceptional patient financial services.

Employment Type: Full-Time