Health First Rockledge , FL 32956
Posted 3 weeks ago
POSITION SUMMARY:
The Revenue Cycle Specialist II will be responsible for the review, minor analysis, trending and follow up of Third Party Claims Reimbursements to include the identification, billing and collection of payments. The Revenue Cycle Specialist II will actively engage with other departments to ensure timely resolution of all outstanding accounts to ensure maximum reimbursement.
PRIMARY ACCOUNTABILITIES:
Apply advanced knowledge of payer contracts, payment polices, and regulations to ensure correct payment of claims
Demonstrate thorough knowledge of complex insurance correspondences to include explanation of benefits, remittance advices and denial letters.
Verify insurance benefits, understanding insurance payments, denials and correspondences through Advanced understanding and ability to navigate payer websites and vendor applicable systems
Maintain established quality assurance and productivity benchmarks while utilizing best practice standards established.
Process all referrals in timeframe established by department
Accurately update account in all systems to reflect work being preformed
Apply logic and critical thinking to identify payer trends resulting in payment delays
Communicate identified payment trends to leadership promptly and accurately and provide solutions to resolve challenges and issues.
Assist with training and mentoring of new hires
Ensure compliance with state and federal laws regarding all aspects of role.
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities.
MINIMUM QUALIFICATIONS:
Education: High School Diploma or GED
Licensure: None Required
Certification: None Required
Work Experience in Related Field: One year experience in Healthcare Billing and/or AR follow up or related field
Work Experience in Lieu of Degree: N/A
Knowledge/Skills/Abilities: Microsoft Office
PREFERRED QUALIFICATIONS:
Education: High School Diploma required or GED
Licensure: None
Certification: None
Work Experience in Related Field: Two year progressive experience in Healthcare Billing and/or AR follow up or related field.
Work Experience in Lieu of Degree: N/A
Knowledge/Skills/Abilities: Critical thinking, Decision-making skills
PHYSICAL REQUIREMENTS:
Sedentary
Sedentary work involves sitting most of the time
Walking and standing or lifting more than 10 pounds are required only occasionally
Must be able to tolerate long periods of computer time a day
Must be able to tolerate long periods of phone time a day
Ability to enter information using hand/wrist dexterity
Visual acuity and hand-eye coordination to preform various tasks
Health First