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Role Description

This role involves managing the revenue cycle by expediting and maximizing payment and resolution of insurance medical claims.

• Resolve edits, denials, and payment issues in a timely manner.
• Document clear, concise, and complete follow-up notes in the system for each account worked.
• Ensure accounts are completed and worked at a high level of quality using HRO tools and monitoring output.
• Identify, analyze, and escalate trends impacting AR collections.
• Exceed established productivity goals.
• Complete special projects to improve team performance as assigned.
• Demonstrate expertise of all payors, including Medicare, Medicaid, and commercial payors.
• Ensure protection of private health and personal information; adhere to all HIPAA compliance requirements.
• Participate in educational activities and attend in-person meetings as required.
• Remain current on collection and follow-up procedures of various payors and specialty departments.
• Assist with knowledge sharing, payor, and department training, and provide support to other team members as advised by leadership.
• Demonstrate strong technical skills and account resolution abilities.

Qualifications

• H.S. Diploma or Equivalent Required
• Associate's Degree in Business or healthcare related field Preferred
• 2 Years of PB AR management, insurance follow-up, insurance billing, or relevant revenue cycle experience Required
• Preferred Experience: Epic knowledge, experience with Home Infusion, payor knowledge, claims processing, rebilling/refunds, credit balance resolution

Requirements

• Strong work ethic and a high level of professionalism.
• High level understanding of health insurance billing, follow-up, credits, regulations, and payer requirements.
• Proficient computer and EMR skills, including Microsoft Office suite applications such as Word and Excel.
• Strong communication and organizational skills.
• Proven experience in a billing environment.
• Ability to shape communications to the needs of the audience.
• Knowledgeable of HIPAA, state and federal regulations governing confidentiality, release of information, and record retention.
• Familiar with Electronic Medical Record (EMR) functionality, document imaging, and workflow; Epic Care Connect EMR experience and certifications are a plus.
• Dependable self-starter and deadline driven.
• Ability to work well independently and in a team setting to meet organizational goals.
• Solid understanding of key revenue cycle workflows, technical systems, and metric goals.

Company Description