Senior Revenue Cycle Specialist:Collections

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Job description

Description:

This is a 100% remote position. All necessary equipment and training to be successful in this position will be provided.

Schedule: 8-hour shift (Overtime available); regular business hours. Monday -Friday

Client seeks to grow our Senior Insurance Collections Team concentrating on Special Projects. This role's responsibility is to seek out and maximize reimbursement from various insurance plans by resolving complicated denials, short payments, billing errors, and other claim issues. The ideal candidate is a self-motivated individual that demonstrates strong critical thinking skills and can resolve complex problems with little leadership guidance or intervention. Individuals who excel in this role are ambitious, results-driven, and robust in root cause analysis. In addition, this position requires attention to detail, strong written and verbal communication skills, and the ability to work well as part of a fast-paced team.

Essential duties and responsibilities:

Work assigned lists of outstanding claim balances and patient accounts with multifaceted issues across different payers and patients

Identify trends, conduct follow-up, and perform root cause analysis on unpaid and underpaid insurance claims across different payers

Perform actions towards remediation of outstanding balances according to policy and procedure; including but not limited to in-depth research, appeals, rebilling, obtaining insurance authorizations or referrals, correcting coding, calling the payer or clinic, and utilizing payor portals

Resolve issues related to a patient's coordination of benefits (COB), demographic discrepancies, insurance eligibility or authorizations, and referrals as needed

Address patient benefit-related denials, including phone verification of plan requirements, financial risk, as well as other factors that may impact reimbursement

Navigate through various payer systems, provider portals, and internal Client applications to ensure timely and accurate claim resolution

Regularly calls payers, employers, and patients

Demonstrate ability to build strategic business relationships with internal and external partners (i.e., Billing & Coding Team, Registration Department, Credit Department, clinical teammates, and the payer(s

Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims

Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and Client policies

Skills:

Proficiency in Microsoft Office tools, including Excel, PowerPoint, Word, and Outlook (required)

Experience working in healthcare revenue cycle; emphasis on collections (2+ years) (required)

Experience obtaining insurance authorizations and sorting out coordination of benefits (preferred)-knowledge of retro authorizations and referrals is a plus!

Ability to confidently place phone calls to payers, clinics and patients

Education:

High school Diploma or equivalent (required)

Associates or Bachelor's degree (preferred)

• Only those lawfully authorized to work in the designated country associated with the position will be considered.

• Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.

Benefits:

For information and details on employment benefits offered with this position, please visit here . Should you have any questions/concerns, please contact our HR Department via our secure website .

California Pay Equity:

For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here .

Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances.

If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise, please contact our HR Department .

Rose International has an official agreement (ID ), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.).

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