Revenue Cycle Specialist at Medical Guardian

MedScope, a division of Medical Guardian is a rising leader in the medical alarm industry, seeks a seasoned Revenue Cycle Specialist with health insurance claims experience to fill a role in the Billing Department. In this role, you will use our customized system in tandem with other applications to send recurring monthly claims and invoices, receive payments, and respond to denials of payment with the goal of resubmitting for payment. You will also perform monthly/quarterly payment audits, analyze the reasons for denied payments or returned claims, and work toward resolution. Ability to analyze data and think critically a must. 

This is a full-time, remote position requiring a daily schedule of 9:00am-5:00pm EST. 

Permanent residency in one of the following states is required: PA, DE, GA, MI, NC, TX, NJ, and FL only.

Key Duties and Responsibilities:

• Monthly submission of invoices/claims, electronic and on paper, in large and small batches.
• Payment application through our customized system.
• Review and examination of non-paid invoices/claims, to work through the denial resolution process for resubmission or other appropriate resolution.
• Month end reporting and analysis of accounts, large and small, including deciphering the reason(s) for invoices that are open and unpaid after aging for 90 days.
• Audit accounts for payment and analyze the reason(s) that payment has been denied.
• Phone work as needed, including customer interactions and receiving payments over the phone via credit card.

Requirements

• Proficiency in the Microsoft Office suite of applications required.
• Strong analytical and mathematical skills.
• Intelligent individual with excellent oral and written communication skills.
• Critical thinking - ability to decipher when things are missing or incorrect.
• Accurate and organized with the ability to multitask.
• Friendly phone demeanor - will be in direct contact with customers and referring sources.
• Must be able to work both independently and collaboratively on a small team, and be accustomed to working with deadlines.
• Punctual and reliable with a professional appearance and demeanor.

Desired Experience:

• Associate or bachelor’s degree (preferred) in healthcare or a related field; high school diploma required.
• 1+ years of previous revenue experience.
• Billing/coding certification preferred.
• Coursework or experience with medical billing, 1500 claim forms, service authorizations, or previous experience with billing in a medical office.
• Experience with Medicaid and Managed Care Organization a plus.

Benefits

• Health Care Plan (Medical, Dental & Vision)
• Paid Time Off (Vacation & Public Holidays)
• Short Term & Long Term Disability
• Retirement Plan (401k)