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.