Job Description

REVENUE CYCLE ACCOUNT SPECIALIST

MISSION: MAKE IT BETTER: PEOPLE, PLACE, AND COMMUNITY

PERMISSION TO PLAY VALUES: KINDNESS, RESPECT FOR OTHERS, COLLABORATIVE AND RELIABLE

POSITION INFORMATION:

HCM is a women-owned business (WOSB) focused on driving engagement and resolutions that align with our client needs. HCM works as an extended business office within revenue cycle where we engage, identify, and present solutions to meet patients financial situation. Further upstream in revenue cycle, we partner to solve pain-points within the claim process. Lastly, like any business, we are open to new ideas and are working to pursue new data-driven and technology focused solutions to provide value within healthcare and beyond.

HCM is looking for a motivated and compassionate REVENUE CYCLE ACCOUNT SPECIALIST__S to drive great outcomes that make a difference for our clients. The combination of exceptional customer service and knowledge surrounding healthcare billing are the professional qualities HCM seeks for our team.

If you are looking to join a dynamic and growing organization to jump start your career, HCM is the place for you!

You can learn more about what we do by visiting the HCM website at www.hcmar.com.

The REVENUE CYCLE ACCOUNT SPECIALIST works directly with our insurance team and is responsible for timely and accurate follow-up and appeal of denials/rejections received from third-party payers. The representative will manage their assigned work to ensure payer appeal/filing dead lines are met and achieve optimal payment for account receivable payment delays.

DEPARTMENT/DIVISION: Accounts Receivable Optimization

ESSENTIAL FUNCTIONS: Monitors insurance work queues and reports in accordance with assignments from direct supervisor. Maintains required levels of productivity while managing tasks in work queues to ensure timeliness of follow-u p and appeals.

• Organizes denial, rejection and or aged accounts related tasks to identify patterns and/or work most efficiently (e.g., by current procedural terminology. diagnosis, payer, etc.)
• Identifies and monitors negative patterns in denials/rejections. Escalates accordingly to management and the impacted department(s) to avoid negative impact on reimbursement. unsuccessful appeals, and/or increased write-offs.
• Uses identified and known resources to accomplish insurance follow-up on tasks. Identifies other means and resources to complete tasks, as applicable and appropriate.
• As needed, participates in A/R clean-up projects or other projects identified by direct supervisor or management.
• Works with hospital or practice to resolve A/R and payer issues. Communicates with other management partners and or hospital designated contacts on issues that may have negative impact on their cash flow, timely claim reconsideration/filing, failed appeals, and/or increased denials and write-offs.
• Participates in departmental and team meetings involving discussions of A/R processes and trends to improve the client partners cash flow at the same time reducing account receivable days

REQUIREMENTS

The ideal candidate for this position will possess the following qualifications and skills

• Some billing and/or coding experience a plus
• Knowledge of hospital revenue cycle or physician/lab billing office or UB-04 billing experience a plus
• High school diploma or equivalent is required.
• Ability to identify the cause of rejections/denials and selecting the most appropriate method for resolution.
• Proficiency with timely and successful appeals to insurance companies.
• Detail oriented and able to deliver neat and organized work.
• Self-motivation and ability to demonstrate initiative, excellent time management skills, and organizational capabilities.
• Must be able to multi-task in a fast-paced environment and appropriately handle overlapping commitments and deadlines.
• Excellent analytical skills and creative problem-solving skills.
• Knowledge of medical terminology and billing/collection practices.
• Read and interpret insurance explanation of benefits (EOBs).
• Preferably knowledge of payer edits, rejections, rules. and how to appropriately respond to each.
• Ability to create professional correspondence to insurance companies and patients.
• Strong-oral and written communication skills.

BENEFITS

• Monday - Friday / No weekends
• Competitive Medical insurance (PPO or HDHP)
• Competitive starting wage
• Dental & Vision insurance
• 401(k) retirement plan with matching contributions
• Long-term disability coverage (Employer funded)
• Life insurance (Employer funded)
• AD&D (Employer funded)
• Short-term disability coverage
• Hospital Indemnity
• Voluntary Life Insurance
• Accident coverage offerings
• Cancer coverage offerings
• Critical illness offerings
• Flexible spending accounts
• HSA employer contributions
• Casual dress
• Competitive Paid Time off (PTO) package
• Paid Holidays