RCM SPECIALIST
Job Description
Job Description
MINIMUM QUALIFCATIONS :
- Computer skills
- Phone etiquette
- Interpersonal skills
- Insurance claims experience and reporting
- Hospital and / or medical facility setting work experience
ESSENTIAL FUNCTIONS :
- Responsible for working and posting claims of patients covered under private and public plans while posting appropriate updates and statuses in the RCM system
- Correcting patients' basic information, account status and insurance verification if incorrect
- Daily insurance claim submission and follow-up
- Regular claims status reports
- Handles correspondence from insurance companies or patients and communicates out as appropriate via email, phone, portal
- Correspondence, forms, and other materials to outside agencies
- Research / process credits (recoupments and refunds) to insurance companies and patients as appropriate
- Coding and policy change maintenance with insurance companies
- Must be familiar with and remain updated on ICD-10, CPT codes, and medical terminology
- Any other duties and tasks as assigned
- Able to utilize and leverage Microsoft Office products (PowerPoint, Excel, Word, Outlook)
- Experience with Modernizing Medicine practice management system and orthopedic billing and collections a plus
EXPERIENCE / EDUCATIONAL REQUIREMENTS :
Education :
Graduate of four-year high school or equivalent (GED)
Experience :
Three to five years healthcare RCM experience related to the described duties
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