Biller / Revenue Cycle Management Specialist - KPH Healthcare Services

Job Summary: The Revenue Cycle Management Specialist is to support the process of the company's billing function.

Job Duties:

• Report any misconduct, suspicious or unethical activities to the Compliance
• Ensure verification of current coverage with third party payers and obtain authorizations as
• Assist in the preparation and submission of claims for payment from third party payers, and invoices for patient co-payments.
• Support the resolution of billing issues such as claim resubmissions to all payers, changes in coverage, and claims
• Communicate as required with patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries about
• Review and approve refunds of third-party payer and patient overpayments.
• Assist in record keeping so that all information is accurate and complete and manage the flow of up-to­ date information between billing department and other parts of the company, such as the accounts receivable, accounts payable and customer service
• Ensure the implementation of processes to measure, assess, and improve the performance of the billing department activities of the company.
• Review and suggest changes to billing department policies and procedures as needed.
• Ensure ongoing compliance with all laws and regulations; ensure that the department meets or exceeds accreditation standards; and implement "best practices" in all departmental \
• Participate in surveys conducted by authorized inspection
• Participate in the company's Performance Improvement program as requested by the Performance Improvement
• Participate in company committees when
• Participate in in-service education programs provided by the company.
• Pursue continuing education programs appropriate to job
• Perform other duties as assigned by
• Responsible for completing all mandatory and regulatory training programs
• Perform other duties as assigned

Educational Requirements:

• High school diploma or GED

Experience:

• One to three years of experience in Home Nursing/Services or related organization

Credential/Licensure Required:

• Must be a licensed driver with an automobile that is insured in accordance with state and agency requirements and is in good working order

Special Conditions of Employment:

• Drug test
• Initial and continuous exclusion and sanction/disciplinary monitoring
• Any and all additional eligibility requirements based on the specific position

Job Skill Requirements:

• Complies with accepted professional standards and practice
• Has satisfactory references from current employers and professional peers
• Has excellent observation and communication skills
• Is self-directed with the ability to work with little supervision
• Is flexible and cooperative in fulfilling obligations