Revenue Cycle Specialist II

Reporting to the Revenue Cycle Manager, the Revenue Cycle Specialist II is responsible for managing accurate, timely completion and submission of multiple third party payers including, but not limited to, Medicare, Medicaid, commercial carriers and self pays as well as collections and accounts receivable functions respectively.

EDUCATION AND QUALIFICATIONS:

High school diploma/GED required. Associates preferred.

Two-to-four years’ experience in health care billing and collections.

Billing information systems knowledge preferred.

Working knowledge of home health, hospice and physician billing preferred.

Knowledge of Microsoft Excel preferred.

Knowledge of governmental regulations and billing guidelines preferred.

ESSENTIAL JOB RESPONSIBILITIES:

Ensures reimbursement through efficient, accurate and timely billing process for effective accounts receivable management.

Work pre-billing report for assigned payers in preparation for month end close.

Generates claims for submission to payers in accordance with established schedule.

Utilizes technology to manage clearinghouse and payor accept/reject submissions and reports timely.

Responsible for accurate posting of cash payments and preparation of cash balancing process.

Review A/R reports and research unpaid claims. Takes necessary steps to collect unpaid claims and address credit balances. Provide reports to the Patients Account Manager as needed.

Process correspondence and telephone calls from all payors regarding claims.

Complete appeals on underpaid claims to the payer.

Identify, prepare, and submit patient account adjustments to Revenue Cycle Manager and post in electronic health record (EHR) once approved.

Assist as needed with payer authorizations and verification as required and completed documentation in electronic health record (EHR).

Protects the confidentiality of patient and organization information through effective controls and supervision of billing operations.

The incumbents may be requested to perform job-related tasks other than those stated in this description.