Revenue Cycle Specialist I / Hybrid / Full Time (251) - Sharp Community Medical Group
San Diego, CA 92123
About the Job
Description
Position Overview:
Metis Practice Solutions is a professional management services organization that values caring, collaboration, and commitment to the independent medical practices in the San Diego community. The Revenue Cycle Specialist ’s role supports our business by proactively working the accounts receivable to include follow-up, appeals, and denials and utilizing complex problem-solving skills to contribute to the organization’s revenue. The primary focus of the Revenue Cycle Specialist is to serve as a liaison to patients and clients, provide billing assistance and general support, and always protect patient and employee confidentiality.
Duties and Responsibilities:
- Generates revenue by working with patient accounts to include making payment arrangements, collection on accounts, and monitoring and pursuing delinquent accounts.
- Customer Service – answering incoming patient billing and health plan inquiries on daily basis.
- Outbound and inbound phone calls to insurance companies, verifying insurance eligibility and benefits.
- Verifies claim status including working on denials, and appeal status.
- Verification of patient statements; verify patient statements are accurate before sending documents out to patients.
- Maintains work operations by following policies and procedures and reporting compliance issues.
- The ability to maintain a high level of confidentiality with knowledge of HIPPA regulations.
- Problem-solving and ability to research and resolve discrepancies, denials, appeals, collections.
- Adheres to professional standards, policies and procedures, federal, state, and local requirements and standards.
- Triage priorities, delegate tasks if needed, and ability to handle conflict in a reasonable fashion.
- Enhances billing departments and practice reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.
- Other duties as assigned.
Qualifications:
- High School diploma required.
- Medical Insurance billing certificate preferred.
- 1-3 years medical billing experience.
- 1-3 years customer service experience preferred.
- Comfortable using math processes.
- Proficiency with electronic practice management (EPM) electronic medical records (EMR).
- Knowledge of Microsoft Office products.
Competencies & Success Factors:
- Knowledge of insurance guidelines, including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems
- Knowledge of CPT/ICD/HCPS coding
- Knowledge of medical terminology and HIPPA regulations
- Ability to multitask and prioritize well
- Competent use of computer systems, software, and 10 key calculators
- Excellent written and verbal communication skills
- A calm manner and patience working with either patients or insurers
- High level of customer service
- Ability to work well in a team environment
- Able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion
- Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
- The ability to maintain a high level of confidentiality
- Adhere to all company policy and procedures
What We Offer:
- Competitive hourly salary range: $24.09 - $29.91 - $33.25 (Based on experience)
- Comprehensive benefits including Medical, Dental, Vision, Short-Term and Long-Term Disability, and 401K.
Metis Practice Solutions is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, marital status, status as a protected veteran, or status as a qualified individual with disability.
Source : Sharp Community Medical Group