National Hispanic Medical Association (NHMA) · 12 hours ago
Revenue Cycle Specialist Remote
Daytona Beach, FL
Full-time
Remote
Entry Level
1+ years exp
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Responsibilities
Responsible for performing and processing accurate billing procedures for all payors, electronically through SSI (a medical claims management system that assists AdventHealth Patient Financial services (FH PFS) insurance reimbursement team with claims editing and validation). Works independently, meeting time and daily deadlines in an accurate and efficient manner, communicating any issues to leadership.
Ensures expeditious and accurate insurance reimbursement for all Government and Managed Care payors. Updates a high volume of daily claims appropriately in SSI system.
Monitors and audits status of errors assigned to other areas or PFS teams for all payors daily, ensuring timely follow up and expeditious billing. Communicates with key management staff and supporting department partners effectively and professionally, to ensure key metrics are being addressed timely.
Maintains communication between external or contracted agencies, business vendors and partners, AH department (i.e. Revenue Management, Laboratory, Contract Management, Case Management, Payors, etc.…) ensuring compliance between external relationships, knowledge of contractual terms, and performance protocols.
Processes and records agency audit notifications and responds in designated timeframe to ensure compliance with government and/or contractual requirements for timely response.
Works all assigned insurance payers to ensure proper reimbursement on patient accounts to expedite resolution. Processes medical, administrative, technical appeals, request refunds when applicable, and rejections of insurance claims.
Analyzes daily correspondence (denials, underpayments) to appropriately resolve issues. Responds to written correspondence received from Payer and/or Patients.
Is responsible to stay current on all active, assigned accounts which prevents abandonment, uncollected account receivables.
Assists Customer Service area with patient concerns/questions to ensure prompt and accurate resolution is achieved. Ensures we foster a team-spirited approach while interacting with co-workers, peers, management, etc.
Qualification
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Required
High School diploma or GED required.
One-year experience in healthcare, finance, accounting, banking, insurance, billing, or related fields.
One year of college can be substituted for experience.
Benefits
Benefits from Day One
Paid Days Off from Day One
Student Loan Repayment Program
Career Development
Whole Person Wellbeing Resources
Mental Health Resources and Support
Company
National Hispanic Medical Association (NHMA)
Established in 1994, The National Hispanic Medical Association is a non-profit association representing 50,000 licensed Hispanic physicians in the United States.
11-50 employees
Funding
Current Stage
Early StageLeadership Team
Elena Rios, MD, MSPH, MACP
President & CEO
Jeanne Duvall
Chief Financial Officer
Company data provided by crunchbase
