POSITION SUMMARYThe Revenue Cycle Specialist II will be responsible for the review, minor analysis, trending and follow up of Third Party Claims Reimbursements to include the identification, billing and collection of payments. The Revenue Cycle Specialist II will actively engage with other departments to ensure timely resolution of all outstanding accounts to ensure maximum reimbursement. PRIMARY ACCOUNTABILITIES1. Apply advanced knowledge of payer contracts, payment polices, and regulations to ensure correct payment of claims2. Demonstrate thorough knowledge of complex insurance correspondences to include explanation of benefits, remittance advices and denial letters.3. Verify insurance benefits, understanding insurance payments, denials and correspondences through Advanced understanding and ability to navigate payer websites and vendor applicable systems 4. Maintain established quality assurance and productivity benchmarks while utilizing best practice standards established. 5. Process all referrals in timeframe established by department6. Accurately update account in all systems to reflect work being preformed7. Apply logic and critical thinking to identify payer trends resulting in payment delays 8. Communicate identified payment trends to leadership promptly and accurately and provide solutions to resolve challenges and issues.9. Assist with training and mentoring of new hires10.Ensure compliance with state and federal laws regarding all aspects of role
MINIMUM QUALIFICATIONS Education: High School Diploma or GED Licensure: None Required Certification: None Required Work Experience in Related Field: One year experience in Healthcare Billing and/or AR follow up or related field Work Experience in Lieu of Degree: N/A Knowledge/Skills/Abilities: Microsoft Office – Outlook, Word, Excel, PowerPointPREFERRED QUALIFICATIONS Education: High School Diploma required or GED Licensure: None Certification: None Work Experience in Related Field: Two year progressive experience in Healthcare Billing and/or AR follow up or related field. Work Experience in Lieu of Degree: N/A Knowledge/Skills/Abilities: Critical thinking, Decision-making skills
Job: *Medical Billing
Organization: *Health First Shared Svcs Inc
Title: Revenue Cycle Specialist II - Patient Business Services
Location: Florida - Brevard County-Rockledge
Requisition ID: 070587