Overview
The Revenue Cycle Billing and Coding Specialist is responsible for the management of accounts receivable through collaboration with the provider offices / care centers.
The specialist will perform timely follow up and collection of unpaid charges, research policies, re-bill corrected claims, appeal denials, process refunds, and perform adjustments, among other tasks.
The ideal candidate will have two years' experience in medical billing or experience in an insurance claims environment and CPC certification.
Responsibilities Related Duties : Oversight of revenue cycle and accounts receivable of multiple provider offices / care centers Analyze claim denials for coding or payor policy updates and make corrections as needed Review coding or documentation from provider that may need to be updated to release for billing Generate appeals or reconsideration forms on denied claims utilizing web portals or payor specific forms Help develop claim edits that will help increase cash flow and create clean claims Follow up on authorizations initiated by the front office staff, when necessary Research and provide timely response on patient, insurance and physician inquiries Communicate with provider's offices to discuss accounts receivable issues, payment or denial trends and make recommendations to impact change.
Run denial and accounts receivable reports to help identify trends Coordinate with internal departments, escalate and resolve payment issues Communicate with patients regarding billing issues, when requested Other duties as assigned Qualifications Position Requirements : Minimum of 2 years’ experience in medical insurance processing required CPC / CCS medical coding certification preferred High school diploma required Combination of college degree may be substituted for some level of experience Previous experience working in an OB / GYN environment highly desirable Proficient in Athena Health highly desirable Highly organized and detail oriented Excellent oral and written communication skills, with ability to effectively communicate with all levels within the organization Demonstrated ability to work in a fast-paced office environment.
Advanced Microsoft Office skills required. Microsoft Excel proficiency preferred.
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