Unified Women's Healthcare · 4 hours ago

Revenue Cycle Claims Specialist

Florida, United States

Full-time

Remote

Mid Level

3+ years exp

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Responsibilities

Monitor and execute work on assigned worklists, reports, projects, or team goals.

Research and resolve claims based on assignment, which could include: contacting payers via phone or website, contacting practices, working across departments, writing appeals and facilitating their submission, and all other activities that lead to the successful adjudication of eligible claims.

Design and generate reports for analysis, trending, and subdivision of work to communicate with internal stakeholders.

Manage and resolve posting issues, manage remittance and all correspondence in each of the EMR dashboards daily.

Illustrate excellent knowledge of healthcare industry regarding the revenue cycle and state insurance laws

Meet productivity standards as set by management

Escalate identification of chronic issues with service locations to immediate supervisor

Demonstrate knowledge and understanding of insurance billing procedures as evidenced by the identification of root-causes of claim issues and proposed resolutions to ensure timely and appropriate payment

Educate and communicate revenue cycle/financial information to patients, payers, co-workers, managers and others as necessary to ensure accurate processes.

Determine accuracy of Insurance payments and Initiate, Follow Up, and Respond on payer reimbursement issues

Communicate with Practices and Payers regarding claim denials and payer trends

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Medical Billing & CodingInsurance billing proceduresOB/GYN experienceAthenanetSalesforcePayer processes knowledgeCRM technologyMicrosoft OfficeCustomer service skillsCross-functional collaborationProject management

Required

High school diploma or equivalent

Minimum of 3 years’ experience as a biller, collector, coder, or back-office support staff

Ability to collaborate effectively in a cross-functional team environment

Knowledge of payer processes, local, state, and federal requirements

Excellent written and oral communication skills

Outstanding customer service skills

Advanced knowledge of Microsoft Office

Strong organizational, problem solving and decision-making skills

Ability to prioritize and manage multiple projects and issues effectively and simultaneously

Self-motivated and self-starter who can work well under minimal supervision

Strong attention to detail, research and follow up skills

Ability to work both independently and in a team setting

Experience and knowledge of commercial and governmental insurance payer and clearinghouse portals (Availity, Navinet, Optum, etc.) including billing guidelines and policy updates

Working knowledge of Medical Billing & Coding required