Revenue Cycle Specialist - EMPOWER

GENERAL PURPOSE:

The Revenue Cycle Specialist is responsible for billing, collections, and revenue cycle management functions.

ESSENTIAL FUNCTIONS:

• Prepares and submits insurance claims to appropriate payers

• Ensures claims are received by payer timely correcting, rebilling, or appealing as necessary.

• Follows up with payers to confirm accurate payment. Contacts payers claims departments to address and correct billing errors and omissions

• Generates necessary reports including billing and collections.

• Answer patient questions and advise them on insurance coverage and benefits

• Establish repayment plans and arrangements with delinquent patients

• Stays current with any payer related changes; may be provider specific or regulatory revisions.

• Actively contribute to special projects and offers feedback to improve processes.

• Analysis AR recognizing potential delays and trends with payers such as corrective actions and responds to avoid A/R aging.

• Escalates payment delays/problem aged account timely to Supervisor.

• Additional duties as assigned by Supervisor.

QUALIFICATIONS:

• High School Education or GED

• Medical billing and collections background preferred

• Experience in Home Health, Hospice or Long-term care preferred

• Knowledge of electronic billing via EMR and medical billing software

• Understanding of the requirements of Medicaid, Medicare and Insurance billing is preferred

• Accounts Receivable skills and medical terminology is a plus

• Computer proficiency – MS Office and web enabled applications strongly preferred

• Excel knowledge

ADDITIONAL REQUIREMENTS:

• Willingness to learn

• Self-motivation and the ability to work independently as well as in a team

• Provide quality customer services to internal and external teams

• Must be able to work productively in an environment with high levels of interruption; work efficiently and effectively meeting multiple deadlines and changing priorities with strong attention to detail

• Exceptional organization skills

• Ability to maintain confidentiality

• Ability to effectively communicate with all levels of management

• Strong work ethic: results focus with a strong desire to achieve goals

• Ability to use a computer keyboard and mouse 6-8 hours a day

• Occasionally lift/carry items weighing up to 25 lbs.

• Ability to dial, answer and talk on a telephone for multiple hours a day

• Ability to handle completing a task in high levels of interruption while paying close attention to detail