About This Role
Working as a Revenue Cycle Specialist, you will perform daily activities involved in the reimbursement process, including claims filing, follow-up, and entry of payments and adjustments. This role focuses on ensuring timely and accurate processing to maintain Accounts Receivables and identify repetitive errors for corrective action.
Responsibilities
- Work as part of a multi-disciplinary team to provide answers to inquiries and questions
- Troubleshoot problems and provide information
- Handle intervention or referrals with a professional and respectful customer service focus telephonically and/or in person
- Provide a variety of support services in connection to the day-to-day operations in a health care environment
- Maintain working knowledge of regulatory guidelines for billing
- Provide claim submission for services provided at SEH
- Provide follow up on claims which did not process correctly
- Provide follow up with insurance companies or individuals to obtain accurate reimbursement
- Review correspondence daily for appropriate follow up
- Work closely with the clinical team for accurate charges and modifiers
- Verify third party payer coverage
- Coordinate authorizations when appropriate
- Work closely with the coding team for accurate submission on claim
- Process and follow up on payer denials, consulting with various entities for completion
- Research and resolve client billing problems or issues
- Provide communication on the methods and principles used for billing to the customers and resolve concerns
- Study contractual terms and conditions of payment to ensure payments are made consistent with terms
- Conduct work functions to assist with late charge processes
- Work closely with third party collection vendors for accurate payment records
- Assist patients and their families with applying for financial assistance
- Establish payroll deduction transactions
- Make daily deposits to the bank
- Ensure change fill requests are complete for department’s daily function
- Work with patients to develop self-pay arrangements and payment plans when applicable
- Post payments for both insurance and individuals
- Review accounts and initiate refunds when applicable
- Communicate self-pay balances for upcoming services and collect balances due
- Work with accounting department for accurate financial documentation
- Edit account for correct coverage documentation
- Apply contractual adjustments in accordance with contracts
- Print, scan and index correspondence to the appropriate account
