Revenue Cycle Specialist II, RCM

The Revenue Cycle Specialist II, RCM is a position that calculates and posts receipts to appropriate accounts, verifies details of transactions; performs billing, posting and collection of claims related to specific payers. In this role, you will report to a Manager of Revenue Cycle Management.

Duties/Responsibilities:

• Sort incoming mail daily and distributes mail accordingly

• Scans and saves checks, remits and billing documents to correct locations

• Monitors held billing and coordinate resolution of all issues

• Researches, resolves, and prepares claims that have not passed the payer edits daily

• Changes payer and rebills in EMR

• Understands and follows up on claim denials and ability to follow up on denials

• Assists with appeals

• Submits of waiver requests as needed

• Enrolls with payers for EFT/ERA submissions

• Ensures the coordination of claim activities and designated agencies, and the timely reimbursement of receivables

• Reviews and bills all secondary and tertiary insurances to correct charges, bill forms and supporting documentation (EOBs)

• Achieves and maintains net collections and outstanding receivables goals as defined by company objectives

• Identifies trends related to denials/coding and delinquent claims and communicate effectively with client manager for feedback to the client

• Identifies system/payer issues such as rates, codes, set up and coordinate accordingly

• Reports status of accounts and issues to appropriate supervisors and departments – maintains full transparency of accounts at all times

• Follows requirements through the full cycle until accounts are satisfied, including patient collections and appeals

• Documents, processes and coordinates all write offs and adjustments as needed

• Works with contracting team and management to resolve payer issues

• Works with branches for all questions on accounts

• Troubleshoots system issues and work to resolve issues

• Completes Provider enrollments for EFTs/ERAs

• Responsible for ongoing process improvement

• Coordinates coverage and cross training for the team

• Attends regular meetings with teams and management to ensure open communication

• Ongoing training and mentorship with team

• Sets up payers in EMR and tests/tracks setup to ensure accuracy

• Handles critical accounts and projects, coordinating with management, operations, and payers to ensure issues are resolved

• Leads AR meetings with management, branches and staff as required

• Other responsibilities as assigned

Required Skills/Abilities/Knowledge:

• Excellent verbal, written and computer communication skills

• Able to communicate across all levels of authority within company

• Excellent organization, problem solving, and project/time management skills

• Able to work with multiple teams within the organization to promote viable, ethical, and cost-effective solutions

• Proven track record of successful collections

• Able to effectively deal with change

• Able to complete projects within specific timetables

• Able to successfully interact with people in face-to-face situations as well as by telephone in a professional and effective manner

Education/Experience/Licenses/Certifications:

• Graduate of accredited high school or GED required

• Minimum of two years of experience in health-related accounts receivable and collections
  
   

Benefits + Perks of Joining the Team Select Family

• Medical, Dental, and Vision Insurance

• Paid Time Off and Paid Sick Time

• 401(k)

• Referral Program

Pay Range: $42,000 - 47,000 / year

 

Team Select Home Care reserves the right to change the above job description and qualifications without notice. Team Select Home Care will not discriminate against you on the basis of race, color, religion, national origin, sex, sexual preference, disability, political belief, veteran status, age, or any other status protected by law. Team Select Home Care is an employment-at-will employer.