Sheridan Community Hospital ยท 1 day ago
Revenue Cycle Assistant- Remote (Michigan Residents Only)
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Responsibilities
Efficiently manage patient complaints with respect to billing and collections by phone and in person.
Work with billing staff and insurance payors to resolve unpaid/rejected claims.
Review reports to identify underpayment/overpayment of claims based on contract management, and work with payors to resolve claim errors.
Responsible for monitoring timeliness, and resolving unpaid claims to ensure timely filing.
Verify and process patient refunds to submit to the Revenue Cycle Manager for approval.
Identifies and participates in continuous quality improvement initiatives across the revenue cycle and other functional areas in order to streamline processes.
Monitors billing processes and systems to improve service, data integrity and quality to achieve organizational goals and process outcomes.
Review and track trends of billing process and makes recommendations for problem and issue resolutions based upon findings; reports findings to Revenue Cycle Manager.
Prepares service level metrics and explanatory summaries for review by department head.
Assist Payor Credentialing Coordinator as directed by Revenue Cycle Manager as needed.
Ability to collect data, interpret findings, set priorities and carry out established plan.
Ability to clearly and effectively communicate with providers, management, credentialing staff, insurance payors, patients, and billing staff.
Auditing of documentation to ensure appropriate coding.
Attend Revenue Cycle Committee meetings as required.
Research patient insurance eligibility and benefit information.
Other duties as needed and assigned by the Revenue Cycle Manager.
Qualification
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Required
Conduct research, organize, and evaluate data from various sources and departments directly related to the revenue cycle.
Investigate all payer reimbursements to ensure that we are being paid at the rate agreed upon in our payer contracts.
Review denials and contractual adjustments for all payors and self-pay to verify calculation of appropriate processing.
Assist patients with account inquiries.
Perform any needed claim rebillings/updates/payments.
Assist in the development of goals and strategies for billing and accounts receivables processes and procedures.
Efficiently manage patient complaints with respect to billing and collections by phone and in person.
Work with billing staff and insurance payors to resolve unpaid/rejected claims.
Review reports to identify underpayment/overpayment of claims based on contract management, and work with payors to resolve claim errors.
Responsible for monitoring timeliness, and resolving unpaid claims to ensure timely filing.
Verify and process patient refunds to submit to the Revenue Cycle Manager for approval.
Identify and participate in continuous quality improvement initiatives across the revenue cycle and other functional areas in order to streamline processes.
Monitor billing processes and systems to improve service, data integrity and quality to achieve organizational goals and process outcomes.
Review and track trends of billing process and make recommendations for problem and issue resolutions based upon findings; report findings to Revenue Cycle Manager.
Prepare service level metrics and explanatory summaries for review by department head.
Assist Payor Credentialing Coordinator as directed by Revenue Cycle Manager as needed.
Ability to collect data, interpret findings, set priorities and carry out established plan.
Ability to clearly and effectively communicate with providers, management, credentialing staff, insurance payors, patients, and billing staff.
Auditing of documentation to ensure appropriate coding.
Attend Revenue Cycle Committee meetings as required.
Research patient insurance eligibility and benefit information.
Other duties as needed and assigned by the Revenue Cycle Manager.
Proven experience in healthcare billing.
Sound knowledge of health insurance providers.
Excellent computer literacy and skills with the ability to use PC software (Microsoft Office-Excel, Word, Outlook, Adobe, Skype) with the ability to master programs needed for position.
High level of awareness of pertinent details; excellent organizational skills.
Strong analytic and problem-solving abilities.
Effective and efficient oral and written communication skills.
Must handle pressure effectively.
Professional appearance and demeanor.
Sound knowledge of health insurance provider and payor credentialing processes and requirements.
Strong interpersonal skills.
Excellent customer service skills.
Must be able to work independently.
Ability to maintain confidentiality and HIPAA requirements.
The ability to work in a fast-paced environment.
Preferred
Certified Professional Coder preferred, or related experience and expertise.
Facility multi-specialty visits, ER, PT/OT, wound care, infusion, surgery, Inpatient/Outpatient/Observation, coding and billing experience preferred.
Rural Health Clinic family practice coding and billing experience preferred.
Experience with Quality measures and HEDIS billing requirements preferred.