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U.S. Dermatology Partners · 11 hours ago

Revenue Cycle Transaction Specialist

Tyler, TX

Full-time

Onsite

New Grad, Entry Level

U.S. Dermatology Partners is seeking a Revenue Cycle Transaction Specialist to manage medical billing data entry and serve as a liaison between various stakeholders. The role involves accurate posting of transactions, maintaining patient account information, and ensuring compliance with billing processes.

Health CareHospitalMedicalWellness

Responsibilities

Responsible for accurate and timely posting of patient and insurance transactions including charges, payments, adjustments and refunds into the practice management system

Processes patient and insurance refunds and issue refund checks to appropriate parties

Keys data into computer to maintain billing records and prepare insurance form with data such as names of insurance company and policy holder, policy number, and physician diagnosis

Contacts insurance company to verify patient coverage and obtain information concerning extent of benefits

Generates appropriate paper work, including insurance claim forms (original and re-filed) and collection letters, mails monthly statements to patients

Reviews insurance claim forms for accuracy, retrieving and attaching appropriate dictation for claim, as needed

Reviews insurance payments (Explanation of Benefits – EOB’s), including Medicare and Medicaid payments for accuracy in account information and demographics

Determines adjustments of claims paid at the out-of-network rate to in-network rates, and processes write-offs on these adjustments

Answers patients' questions regarding statements and insurance coverage, answers telephone in a prompt, courteous, and helpful manner, screening calls, directing calls, providing information, answering questions, and taking accurate messages

Responds to all inquiries received from patients and payors either by telephone or written request

Follows-up on unpaid insurance claims after denial, to obtain settlement of claim

Establishes and maintains contacts with payor accounts’ representatives

Reviews accounts receivable activities and calls on outstanding balances or claims

Handles transactions necessary on discharged patients

Completes and files all necessary paperwork for services rendered, i.e., charge tickets, patient forms, medical records, etc

Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service

Performs other duties that may be necessary or in the best interest of the organization

Qualification

Medical billingInsurance verificationAccounts receivable managementPractice management systemCustomer service

Required

Responsible data entry for medical billing from insurance companies (payors) and patients

Serves as a liaison between practices, clinics, the business office, payors, and patients

Establishes and maintains contacts with payor accounts' representatives

Initiates telephone contact and answers all calls pertaining to accounts

Maintains accurate information regarding patient accounts receivable

Maintains strict confidentiality for all patient accounts

Follows approved processes, policies and procedures in executing job duties