Position
Revenue Cycle Sepcialist
Description

The Revenue Cycle Specialist is responsible for all assigned accounts receivable, billing and payments tasks in the revenue cycle. The Revenue Cycle Specialist will work with agency point of contacts and other staff members to ensure an efficient and timely revenue cycle.

Responsibilities

Accounts Receivable

 

  • Collect outstanding balances in a timely manner by applying best practices
  • Utilize Aged Receivables reports to prioritize outstanding balances
  • Submit appeals and corrected claims utilizing the most efficient method available and by following payer guidelines regarding timely filing limitations and documentation requirements
  • Identify and report denial trends and areas of concern
  • Maintain acceptable overall A/R and days outstanding
  • Analyze and prepare monthly financial reports for executive staff and/or agency as needed
  • Assist with other tasks and projects as needed or assigned

 

Billing

 

  • Ability to maintain record and notation of completed work in fiscal software
  • Assistance with special projects
  • Ability to analyze and interpret CMS1500, UB04, 837I, 837P, 835, paper RA, 999, 277
  • Knowledge of electronic claims scrubbing application
  • Ability to submit clean claims utilizing the most efficient billing method per payer
  • Knowledge of regional, state, federal guidelines
  • Analyze and prepare monthly financial reports for executive staff
  • Prepare daily services reports and work with customers to ensure error free charge entry
  • Prepare month end reports as needed for agency
  • Run, review and report 270/271 eligibility data
  • Verify eligibility using most efficient method available for each payer (portal, phone, clearinghouse)
  • Obtain initial and renewal authorizations using most efficient method available for each payer (portal, phone, clearinghouse)
  • Track renewal authorizations
  • Obtain, track and renew credentialing utilizing payer specific forms or CAQH Proview, depending on the payer and agency.

 

Payments

 

  • Posting payments, adjustments, and zero pays to patient accounts
  • Ability to maintain record and notation of completed work in fiscal software
  • Verify and reconcile batch totals with payment bank deposits
  • Maintain record of daily payments, interest, incentives, and penalties for month end reconciliation
  • Responsible for creating, organizing and filing daily payment batch folders
  • Ability to analyze and interpret CMS1500, UB04, 837I, 837P, 835, paper RA, 999, 277
  • Identify and report denial trends and areas of concern
  • Assist with other tasks and projects as needed or assigned
Qualifications

Knowledge, Skills & Abilities:

  • Knowledge of regional, state, federal guidelines
  • Ability to comprehend and provide explanation for outstanding balances
  • Ability to analyze and interpret CMS1500, UB04, 837I, 837P, 835, paper RA, 999, 277
  • Ability to assist in other areas and projects as needed with billing and payments.

 

Qualifications:

  • Associates Degree or Equivalent Preferred
  • 1 Year of Medical and/or Behavioral Billing Experience Preferred
  • Prior Customer Service Experience

Position: Revenue Cycle Sepcialist

Thank you for submitting your application. We will contact you shortly!

Employment Type
Full time
Job Location
15 Washington Street, 03818, Conway
Date posted
May 1, 2019
PDF Export