Anesthesia Claims Specialist - Remote or Hybrid Role! - The Staff Pad

The Staff Pad is seeking a Revenue Cycle Specialist II (RSC)/Anesthesia Claims Specialist for our growing healthcare client in Dallas, Texas. This position offers both remote or hybrid options. The Revenue Cycle Specialist II (RCS)/Anesthesia Claims Specialist is responsible for complex claim trend identification, management, and resolution contributing to the day-to-day operations of all the revenue cycle functions to improve the net collection rate for all member practices.

·           - Insurance and Revenue Cycle Expert Resource

·            -Identification and development of workflow improvements to improve revenue results

·            -Interaction with Anesthesia Practitioners for clinical documentation clarification and missing data elements

·            -Liaison to facility health information management departments for information needed

·            -Liaison to surgeon office health information management team members for information needed

·            -Verification of patient benefits, estimated liability determination and patient communications for pre-collection

·            -Revenue Cycle Project assignments as needed.

·            -MedSuite knowledge and training expert

Principle Responsibilities

*Improved Revenue Results

o   Responsible for identification and resolution of complex claim issues delaying payment 

o   Interface with the anesthesia practitioners as necessary for resolution of clinical denials

o   Workflow and reporting assistance as needed member practice items within available IT applications

*Detail and Monthly Case Information Coordination

o   Responsible for resolving incident and concurrence issues as well as practitioner-identified missing revenue items including professional communication to anesthesia practitioners

o   Interface with the anesthesia practitioners as necessary for resolution

o   Reporting assistance as needed for member practice issues and training needs

o   Responsible for resolution of concurrency issues identified during charge entry if communication with an anesthesia provider or facility is necessary for resolution

o   Administrative support for data needs

o   Administrative support for training documentation and presentation development

*Responsible for Facility Information Management Department relationships

o   Facility information needed for any billing issue resolution for Member Practices

o   Surgeon office information needs for any billing issue resolution for Member Practices

*IT Applications

o   Revenue cycle application training internally as needed for all applicable systems

o   Report generation and/or analysis from as required

*Precollection Processes

o   An understanding and ability to provide back-up for verification of insurance eligibility and benefits for selected patients as required

*Refund Management and Confirmation

o   Responsible for managing monthly refund compliance as dictated for federal and state program compliance

o   Review of refunds as dictated for accuracy and documentation

o   Coordination with Revenue Cycle Vendor and Member Practices as necessary for refund requests and resolution

*Project Management

o   Participate in Revenue Cycle and other projects as needed   

Required Qualifications:  

• Five years medical professional fee billing experience, anesthesia preferred
  
• Prefer coding and/or medical billing certification