Job Description

Essential Functions:

• Collaborate with revenue cycle manager RCM in the planning, implementation, administration, and evaluation of projects that have the potential to increase access revenue, improve service, or results in cost reduction.
• Communicates with personnel in all areas of Spectrum including attending departmental meetings
• Attend all insurance provider representative meetings as well as lead provider meetings when RCM is not present or available
• Strong customer service skills answering client patient and carrier calls prompt return and follow up to all interactions prompt response to requests for information
• Timely management of charge entry and accounts receivable as assigned using the Athena workflow dashboard claims workless self-pay workless patient refund work list and accounts receivable aging wizard
• Effectively handle complex payer denials and front-end rejections
• Liaison with patients and insurance companies to address incorrect coordination of benefits or demographic related issues
• Responsible for ensuring secondary claims and properly formatted submitted and followed up on in a timely manner
• Expertly add specific data such as modifiers payers’ specific information including authorization criteria POS codes CPT and ICD- 10 codes and encounter codes

Minimum Qualifications and Experience:

• Medical terminology certification is preferred
• Billing and coding certification
• High school diploma
• Knowledge of the revenue cycle and how billing and coding affect revenue
• Proficient with Microsoft Word and excel
• Comfort and flexibility working in a fast-paced health environment
• The ability to sit for the majority of the workday
• Proven track record of customer service skills