The Senior Revenue Cycle Specialist will provide guidance and direction to the RCM team by gathering claims information for projects and leading the RCM team on multiple aspects of billing, auditing, cash posting, and collections. In this role, you will report to the Accounts Receivable Manager, RCM
Duties/Responsibilities:
Understands and follows up on claim denials and appeals
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 – always maintains full transparency of accounts
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
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
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
Oversees projects for the full cycle of gathering data to submission and resolution from payor
Gathers data and trends to report to leadership for delays in payments and collections issues
Acts as a resource for existing locations for RCM team
Leads research of new locations, acquisitions and works to ensure timely billing and collections for these locations
Trains RCM staff for new locations and acquisitions to ensure accuracy and knowledge of team
Performs other duties as assigned
Required Skills/Abilities/Knowledge:
Strong skill set in Microsoft Office products
Excels in high pressure environments
Attention to detail with excellent verbal and written communication skills
Strong time management skills
Education/Experience/Licenses/Certifications:
High School diploma
At least two years of medical collections experience
Medical, Dental, and Vision Insurance
Paid Time Off and Paid Sick Time
401(k)
Referral Program
Pay Range: $40,000 - $45,000 / salary
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.