Revenue Cycle Specialist Jobs

Revenue Cycle Specialist

From $10/yr

Position Summary Under direct supervision of the Revenue Cycle Supervisor, this position is responsible for assuring timely collection of accounts receivable, monitoring account activity and providing adequate follow up to ensure maximum reimbursement is received for physician billing. The ideal candidate would have a strong understanding of medical claims billing. * Research and resolve claims denials using the appropriate resources * Check that pre-bill claims are passing internal edits in a timely fashion * Monitor that all denied claims are corrected or appealed * Collaborate with other teams within the business office * Provide appropriate feedback to management. Qualifications * High School Diploma or general education degree (GED) * 2 – 4 years of physician office billing and denial management experience required * Basic Understanding of ICD10, CPT HCPCS * Ability to read and interpret explanation of benefits (EOBs) * Knowledge of Medical Assistance, Medicare Part B and commercial insurance products * Familiar with CMS 1500 * Basic understanding of medical terminology and anatomy. * Athena experience strongly preferred * Excellent communication skills both written and verbal * Must be a self-starter that is detail oriented and capable of multi-tasking * Requires comprehensive knowledge of computer skills including Microsoft Office Suite * Comfortable in a fast-paced working environment of a growing practice Key Responsibilities * Performing collection activities, such as status calls to ensure timely reimbursement, appeals and account review. * Ensuring appropriate information is submitted to insurance companies in order to expedite payment. * Take appropriate follow up actions on accounts to ensure claims are paid on the first follow-up call or appeal. * Determine that appropriate information is submitted to insurance companies in order to expedite payment. * Following up on assigned cases from within the organization * Reviewing pre-bill claim holds to verify that the claim goes out clean the first time * Composing appeals to insurance carriers for denied claims * Handle incoming calls for information request from insurance companies within 24 hours. * Assisting Financial Counselors when patients have questions regarding claims * Corrects accounts that are billed to incorrect insurance companies. * Ensures authorizations are attached to claims * Comply with quantity and quality expectations as provided by management * Communicating with the lead, supervisor and team to advise of trends, issues discovered * All other duties as assigned At FOI our goal is to provide our patients with world-class orthopedic care. Our mission of providing the best care encompasses not only the care the physician provides, but all medical and administrative aspects of the patients encounter with Florida Orthopaedic Institute (FOI) as well. Every staff member plays a vital role in this mission. We take pride in receiving the Patriot Award from the Department of Defense for the support that we give to National Guard and Reserve members who are employed by FOI. We are committed to encouraging a culture of inclusion reflective of the communities we serve, and we provide equal opportunity to all. Florida Orthopaedic Institute conforms to the spirit as well as to the letter of all applicable laws and regulations. What We Offer * Full time opportunities available, with room for career growth and advancement. * Excellent job security and stability, to promote an optimal work life balance. * Be part of this dynamic and growing high level Business Office team! Orthopaedic Solutions Management is a Drug Free Workplace We are committed to maintaining a safe, healthy, and productive work environment. As part of this commitment, we operate as a drug-free workplace. All candidates will be required to undergo pre-employment drug screening and/or be subject to random drug testing in accordance with applicable laws and company policy.

Revenue Cycle Specialist - Orthopedic Billing - IN PERSON ONLY

About us: Plymouth Bay Orthopedics Associates (PBOA) is one of the fastest growing, progressive, comprehensive orthopedic, sports therapy and pain management group on the South Shore/Cape Cod. Our team of friendly and diverse physicians are all board certified in Orthopedic Surgery, Sports Medicine, Physical Medicine and Rehabilitation. We have a team/family-oriented culture with great hours, competitive pay, benefits, and open interaction between our staff and management. Qualifications: Experience with variety of billing issues involving payers (Medicare, Medicaid, private insurance, worker’s compensation) including forms, coding compliance and reimbursement guidelines Thorough knowledge of medical terminology, managed care financial agreements; knowledge of CPT, HCPCS, and ICD-10 codes Knowledge of medical billing/coding/collection practices required Knowledge of medical office procedures required Ability to establish and maintain effective working relationships with patients, employees, and providers Must be well organized and detail-oriented Medical Coding knowledge (Preferred, not required) Microsoft experience required Job Duties and Responsibilities The Billing Specialist is responsible for collecting, posting, and managing account payments The Billing Specialist is also responsible for submitting claims and following up with insurance companies Prepares and submits clean claims to various insurance companies either electronically or by paper If the claim is denied by the third-party payer, the medical billing specialist must investigate the claim, verify its information, and update the database Oversees patient access activities including pre-registration, insurance verification, patient registration, patient check out, upfront collections, billing and medical records and provides general administrative assistance to the provider Evaluates documentation to ensure that appropriate, accurate, and complete information is maintained and appropriate authorizations are obtained Processes payments from insurance companies Prepares, reviews, and sends patient statements Identifies and resolves patient billing complaints Follows and reports status of delinquent accounts Performs various collection actions including contacting patients by phone and correcting and resubmitting claims to third party payers Reviews accounts for possible assignment and makes recommendations to the Billing team leads, also prepares information for the collection agency Answers questions from patients, clerical staff, and insurance companies Maintains strict confidentiality; adheres to all HIPAA/HITECH guidelines and regulations Location: Plymouth MA 02360 Job Type: Full-time Pay: $23.00 per hour Benefits: 401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance Schedule: 8 hour shift Day shift * Monday to Friday Work Location: In person