RI International · 4 days ago
Revenue Cycle Specialist I - Temporary FT
United States
Full-time
Remote
Entry Level
$23.50/hr - $23.50/hr
2+ years expRI International is dedicated to empowering individuals on their journey to recovery, aiming to revolutionize healthcare through innovative solutions. The Revenue Cycle Specialist I will manage and maintain a workload of claims, ensuring timely billing functions and effective communication with insurers to resolve outstanding claims.
ConsultingHealth CareManagement ConsultingTraining
Responsibilities
Responsible for managing and maintaining a workload of approximately seventy (70) claims to resolution daily
Works in conjunction with other RCM staff to assure timely completion of billing functions
Responsible for managing and maintaining a workload of approximately seventy (70) accounts or higher to ensure claim(s) resolution
Review outstanding claims to determine necessary action. Make status calls to insurance companies
Request claims to be reprocessed when necessary and prepare/submit corrected claims or appeals to the insurance companies for payment. Adjust claims that are deemed non-reimbursable
Monitor payer project work queues for both pending and submitted claims; move claims between work queues while documenting
Review underpayments and overpayments, prepare spreadsheet and summarize findings; escalate as appropriate
Post contractual allowances based on fee schedule or expected payment/denial amounts per third party contracts
Contact insurers regarding recoupment payments, double debits, overpaid accounts, and missing checks; initiate dispute process as needed
Call payers to determine the true reason for denial and inquire on what corrections need to be made
Investigate receipt of claims and payer portals to maximize reimbursement
Create and distribute specific reports to staff such as the account detail report, unbilled report and any other claims detail report for proper follow-up as needed
Prepare and submit denied claims targeted project files to payers, track reprocessing of project files
Provide feedback to both department and payers on project status
Maintain tracking sheet of pending/resolved issues and historical payer issues
Schedule and attend departmental meetings/conference calls
Identify problematic claim trends and contract violations and report findings to the Manager and Director
Follow company processes related to submission of corrected claims and appeals
Update insurance information in the system as necessary, initiate and support primary, secondary and tertiary billing
Understands and adheres to RI International compliance standards as they appear in the Code of Conduct and Conflict of Interest Policies
Keeps abreast of all federal and state regulations and laws and all Recovery Innovations policies and procedures as they presently exist and as they change or are modified
Performs other related duties as assigned
Qualification
Required
High school diploma or equivalent
2 years of medical (preferably Behavioral Health) billing and/or A/R experience
Preferable experience in either Arizona and/or Washington markets
Working knowledge of CMS guidelines, contracted insurance guidelines and coding policies
Demonstrated computer skills
Detailed oriented, reliable, and able to multi-task in a fast-paced, high-volume work environment
Intermediate to Advanced proficiency in Microsoft Excel
Must have excellent written and verbal communication, with particular emphasis during telephone calls, follow-ups, and in-person correspondence
Above average computer skills including databases, spreadsheets, interface file maintenance and related computer programs designed for billing, coding, and accounting purposes
Ability to focus on the big picture while attending to multiple detail requirements in a changing environment
Ability to analyze and interpret data
Ability to formulate, recommend and implement solutions
Ability to adapt to change in the workplace and demonstrate the ability to work collectively within a diverse team environment
Ability to use critical thinking and reasoning skills to solve a problem
Ability to provide guidance and feedback to help others strengthen specific knowledge/skill areas
Ability to find a solution for or to deal proactively with work-related problems
Must be at least 18 years old unless residing in a state where funder or government regulations set a different minimum age requirement
Travel required based on business need
Ability to maintain a high level of confidentiality (HIPAA guidelines and regulations) and professionalism
Must have a valid driver license
Must be able to pass a seven-year background check
Must be able to pass substance abuse testing and/or tuberculous testing (if applicable)
Must be able to obtain designated fingerprinting clearance in applicable states
Must be able to pass education verification check
Must be able to pass three-year motor vehicle report and meet minimum eligibility requirements criteria of insurance carrier (if driving is required for this position)
Preferred
Prior training experience is preferred
Benefits
Competitive health, dental, and vision insurance
Access to mental health resources and wellness programs
Strong retirement plan with company matching
Generous paid time off to support work-life balance
Ongoing opportunities for professional development and training
Company
RI International
With more than 51 programs across the U.S. and abroad, RI specializes in Crisis, Health, Recovery and Consulting Services.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
David Covington
CEO & President
Paul Galdys
Deputy CEO
Recent News
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