Revenue Cycle Specialist II (Remote) - #440382

Health Care District of Palm Beach County


Date: 09/15/2021 15:30 PM

City: Belle Glade, Florida

Contract type: Full Time

Work schedule: Full Day

Overview:

The Revenue Cycle Specialist II is responsible for working patient accounts, contacting insurance payers regarding open balances and keeping the account receivables within department standards. This position is responsible for performing billing functions that enable and

expedite collections and performing account research and review of accounts in accordance with A/R guidelines The Revenue Cycle Representative helps improve cash flow and participates in managing the overall health of the company’s receivables. This role is responsible for posting charges and payments in a timely manner, while ensuring documentation complies with all state and federal statutes, as well as the company’s policies and procedures



Responsibilities:

Prepares and submits clean claims to various insurance companies either

electronically or by paper with required documentation as needed. Submits monthly claims billing; follow-up, re-billing, secondary billing and correction billing of claims



Performs various collection actions, including contacting patients by phone, correcting and resubmitting claim to third party payers. Follows up on outstanding insurance payor claims and charges in follow-up work queues and on various reports by contacting insurance carriers and patients for status including processing correspondence



Rebills underpayments, appeals denials and turns them into payments, ensures accurate reimbursement from insurance and government payors on all claims. Audits accounts for proper payments, coding, balances, adjustments, etc. using appropriate

reports and work queues



Ability to review, interpret and understand government, state, commercial and managed care contracts against EOB’s with third-party payers to ensure appropriate reimbursement. Intermediate computer skills including the use of spreadsheet programs and word processing programs



Performs various collection actions, including contacting insurance carriers, confirming claim status using payer web portals, correcting denial errors, and submitting corrected claims to third party payers

Responsible for posting charges for hospital and / or physic an services. Posts payments for patient payment and insurance payments. Prepares, reviews and sends patient statements



Resolve account aging balances; perform insurance verifications when necessary, referrals

and authorization. Ensures aging balances are kept within revenue cycle department days in

A/R standards. Maintains and updates the unbilled report



Responsible for reviewing and interpreting patient accounts as applicable. Reviews patient

bills for accuracy and completeness and obtain any missing information. Makes corrections

or adjustments on accounts as necessary. Reviews insurance reimbursement accuracy and

appeal if necessary. Update patients file records accordingly. Performs in depth audits on accounts to ensure proper collections



Ensures accuracy of insurance claims before billing. Identifies accounts that can be written off to bad debt. Coordinates with other departments for corrections on the unbilled report in a timely manner. Effectively works with assigned insurance carrier(s) to resolve billing issues

Prepare and process request for refunds with necessary documentation and submit to supervisor for approval



Establish and maintain strong relationships with providers, clients, patients and fellow staff. Maintain good communication link with each patient’s home-clinic personnel

Identifies and resolves patient billing complaints. Answers questions from patients, clerical staff and insurance companies. Works effectively with the team to determine & communicate correct billings on the account



Participates in educational activities and attends monthly staff meetings

Performs general office clerical work including, but not limited to, copying files, entering data and answering phones. Routes communications to appropriate personnel as needed

Assists with incoming calls, tasks and inquiries. Maintains patient confidentiality at all times. Other duties or special projects assigned



Health Care District of Palm Beach County is proud to be an Equal Opportunity Employer and Drug Free Workplace. We embrace diversity and do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics



Qualifications:

Education:

High School Diploma or GED required. Associate’s Degree preferred



Experience:

Minimum two (4) years of experience in a hospital, physicians office or other healthcare setting required

Claim Edits and Denials management experience required. Epic revenue cycle application experience

preferred



Certification:

CRCR required.

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