Revenue Cycle Management Specialist

Job Responsibilities: Submits timely, accurate invoices to payer for products and services provided. Understands the terms and fee schedule for all contracts for which invoices are submitted. Correctly determines quantities and prices for drugs billed. Verifies that the services and products are correctly authorized and that required documentation is on file. Ensures that invoices are submitted for services and products that are properly ordered and confirmed as provided. Evaluates payments received for correctness and applies payments accurately to the system. Verifies that payments received are correct according to the fee schedule. Applies the payment correctly to the patient account. Ensures that secondary bills and patient invoices are mailed within 48 hours of receipt of payment. Notifies the Reimbursement Manager if there are overpayments and/or duplicate payments for the same service. Transfers payments belonging to other offices within 48 hours of receipt. Follows up on invoices submitted to ensure prompt and timely payment. Calls to verify that claims submitted were received and are in processing. Sends letters to the patient or responsible party when their insurance carrier fails to make payment reasonable time frame. Generates and mails statements and collections letters. Follows-up on all denials within 48 hours of receipt. Ensures compliance with policies and guidelines outlined in the contract terms and fee schedule. Follows HIPPA guidelines when accessing and sharing patient information to maintain patient and business confidentiality. Supervisory Responsibilities: i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.

asic Education and/or Experience Requirements: High School Diploma or equivalent. 0 – 6 months previous Infusion Reimbursement or Intake/Admissions experience Basic Qualifications & Interests: Basic level skill in Microsoft Excel (for example: opening a workbook, inserting a row, selecting font style and size, formatting cells as currency, using copy, paste and save functions, aligning text, selecting cells, renaming a worksheet, inserting a column, selecting a chart style, inserting a worksheet, setting margins, selecting page orientation, using spell check and/or printing worksheets). Basic level skill in Microsoft Word (for example: opening a document, cutting, pasting and aligning text, selecting font type and size, changing margins and column width, sorting, inserting bullets, pictures and dates, using find and replace, undo, spell check, track changes, review pane and/or print functions). This job description is to be used as a guide for accomplishing Company and department objectives, and only covers the primary functions and responsibilities of the position. It is in no way to be construed as an all-encompassing list of duties. Due to state pay transparency laws, the full range for the position is below: Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.

$16.69-$27.82

Employer: option Care Health
Location: Atlanta, GA
Link: https://optioncarehealth.com/careers/career-search/posting/revenue-cycle-management-specialist/R30389