The Revenue Specialist ensures the financial integrity of accounts receivable by performing established financial processes that enable and expedite billing and collection for medical services. This includes posting EOBs, editing and resolving claims according to regulations and compliance guidelines, patient account research and resolution, insurance verification and benefit determinations, identification of reimbursement issues, resolution of credits and issuance of refunds, identification of payment variance on invoices and follow-up and resolution of denied claims. This role is responsible for working correspondence denials and insurance follow up. This must be done in a timely and accurate manner, in accordance with provided work instructions.
Job Responsibilities include, but are not limited to:
- Post all the EOBs, work on claim worklists, AR worklists, reporting, projects, to ensure timely charge capture
- Research and resolve claims based on assignment, which could include: contacting payers via phone or website, contacting practices, working across departments, writing appeals and facilitating their submission, and all other activities that lead to the successful adjudication of eligible claims
- Run reports for analysis, trending, and subdivision of work to communicate with internal stakeholders
- Manage and resolve posting issues, manage remittance and all correspondence in each of the EMR dashboards daily
- Manage and resolve the zero-pay worklist and fully worked receivables, complete special project work, review and respond to adjustments and payment data, and communicate trends and root issues through proper lines of reporting
- Work with and provide support to staff, which may include trainings and issue resolution
- Illustrate excellent knowledge of healthcare industry regarding the revenue cycle, coding, claims, and state insurance laws
- Ensure resolution of patient cases
- Meet productivity standards as set by management
- Inform management of correspondence and communication problems with service locations
- Maintain knowledge and understanding of insurance billing procedures to understand the reason for claims requiring edits
- Educate and communicate revenue cycle/financial information to patients, payers, co-workers, and others as necessary to ensure accurate processes.
Job Type: Full-time
Pay: $25.00 – $35.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Schedule:
- Monday to Friday
Ability to commute/relocate:
- Englewood, CO 80112: Reliably commute or planning to relocate before starting work (Required)
Education:
- Associate (Preferred)
Experience:
- Medical billing: 3 years (Required)
Work Location: One location
Source: Indeed.com
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