Remote Specialist-Revenue Management

Remote Full-time
Position Summary This position is 100% remote. We will only consider remote applicants residing in the following US states ? AL, AZ, CT, DE, FL, GA, IN, KS, KY, LA, MD, MI, NC, PA, RI, SC, VA, WV, and WI. The AR management specialist works with unique department billing/collection functions to assure accounts are managed accurately and timely. Responsibilities will vary based on department need. Minimum Requirements Education ? High School Diploma or equivalency Experience ? 4 years medical office or medical billing in a hospital or physicians billing setting, collections or coding experience. ? Must possess strong knowledge of CPT, HCPCS and ICD-9/10 codes. ? Must be efficient in reading insurance explanation of benefits (EOB) and understanding of remittance and remark codes. ? Good working knowledge of Microsoft Excel ? Good communication skills and the ability to interact well with multiple departments/levels of management License/Registration/Certifications ? N/A Preferred Requirements Preferred Education ? N/A Preferred Experience ? In depth knowledge of all payer billing and eligibility requirements Preferred License/Registration/Certifications ? Certified Procedural Coder (CPC) (CPC-H) ? Certified Revenue Cycle Associate (CRCA) ? Certified Medical Insurance Specialist (CMIS) ? Registered Health Information Technician (RHIT) Core Job Responsibilities ? Responsible for research and resolution of all outstanding patient and insurance credit accounts, any additional A/R management research and account updates required to ensure claims are filed to the appropriate carrier or posted correctly. ? Processing of all refunds or credit reversals in a timely manner as defined within the departmental credit/refund policy/procedures. ? Responsible for all government monthly credit reporting preparation and requirements ? Responsible for accurate charge capture, charge review, claim edits, posting to the AR system and resolution of all charge edits. ? Responsible to handle all denials related to charge capture for improved integrity of charge capture ? Responsible to accurately update patient demographics, insurance registration information, verification of insurance, etc. ? Responsible for the consolidation of duplicate guarantor/patient accounts within the AR management system in an accurate/timely manner. ? Responsible for the review and processing of Accounts Receivables reports to ensure revenue integrity. Reporting trends identified during the analysis. ? Responsible to research and complete a detailed analysis of all payer variances based on our Contract modeling within our AR system. ? Revenue Management Specialist must have the skill set and understanding of payer and government payer contracts/schedules in order to confirm expected reimbursement amounts are correct. ? Work closely with other departments on revenue integrity issues including variance contract build issues, charging issues, A/R type issues and other items as define. ? Responsible for all account financial changes and refiling of those claims to the appropriate payer source. ? Assist with payer/physician credentialing and system table management. ? Responsible for electronic remittance, eligibility and claims agreements to insure the proper processing of electronic transactions, electronic remittance requirements and other payer requirements for billing. ? Responsible for the processing of all vendor claim updates, returns and resubmissions for payment. ? Other duties as assigned. Location: Spartanburg Regional Healthcare System · Business Services Schedule: Full-Time, Days Apply Job! Apply tot his job
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