Job Description
The Revenue Cycle Specialist is a vital aspect of our billing team who is responsible for daily billing/submissions of claims, correcting and monitoring rejections, third-party follow-up, and reviewing payments posted, among other duties. Essential to this position is the ability to communicate clearly and concisely, verbally and in writing, establish and maintain long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
Validate all pertinent treatment information in order to submit accurate claims.
Ensure all patient demographics and payer information are accurate
Submit all claims to clearing house and work rejections, as needed.
Communicates directly with the payor, resubmits denied claims, underpaid claims and claims that are inaccurately processed. Receives the denied claims and researches appropriate steps.
Run reconciliation to ensure completion of open tasks.
Prepares, posts, verifies, and records customer payments and transactions
Identifies delinquent accounts by reviewing files and reports delinquent account holders.
Review posted payments for reimbursement according to contract and accuracy
Provide effective communication to patient/family, team members, and other health care professionals and maintain confidentiality.
Review payer contracts to ensure billing and reimbursement compliance and accuracy
Ensure that all patient accounts are properly and completely documented
Assists the Accounting Department in reconciling revenue accounts.
Collaborates with necessary departments in order to drive process improvement
Relays changes of information to appropriate employees and leaders.
Investigate and resolve customer queries
Qualifications