Revenue Cycle Specialist II
Location
Ohio
Posted
7 hours ago
Salary
0
Seniority
Junior
Job Description
Revenue Cycle Specialist II
University Hospitals
• Position responsible for submitting and resolving medical claims moderate to high complexity. • Must remain current with governmental and third party billing, follow-up and appeal requirements for compliant billing and follow-up of both inpatient and outpatient claims for all wholly owned facilities and physician entities including internal and external policy requirements. • Responds to requests from management, staff, or physicians in a timely and appropriate manner. • Maintains patient and physician confidentiality and professionalism at all times. • Follow department policies and procedures to ensure accurate and timely claim resolution. • Effectively communicates utilizing telephone, form letters, e-mail, or internal correspondence to resolve patient inquiries and insurance issues. • Attends and participates in team meetings. • Utilizes worklists to review and analyze account balances in order to collect payment for medical services rendered. • Utilizes multiple system applications to review, update patient information as well as research and resolve outstanding AR balance. • Assists in the analysis of claims resolution and provides feedback to management for solutions and process improvements. • Performs follow up with insurance companies to ensure appropriate payment on claims, resolve denials, correct claims, and appeal claims. • Acts as a liaison with internal and external customers providing assistance in claims and receivables resolution in a high volume environment. • Documents accounts with clear and concise verbiage in accordance with departmental procedures. • Reviews and responds to correspondence and inquiries received. • Meets and exceeds team productivity and quality standards. • Takes the lead on special projects. • Participates in staff training. • Reviews complex claims issues for resolution and recommends process improvements. • Performs other related duties as assigned.
Job Requirements
- High School Equivalent / GED (Required)
- Associate's Degree (Preferred)
- Bachelor's Degree (Preferred)
- 1+ years medical billing / claim experience (Required)
- Experience with medical billing software (Preferred)
- Must have a working knowledge of claim submission (UB04/HCFA 1500) and third party payers. (Required proficiency)
- Knowledge of procedural and ICD10 coding. (Required proficiency)
- Basic knowledge of medical billing terminology. (Required proficiency)
- Detail-oriented and organized, with good analytical and problem solving ability. (Required proficiency)
- Notable client service, communication, and relationship building skills. (Required proficiency)
- Ability to function independently and as a team player in a fast-paced environment. (Required proficiency)
- Must have strong written and verbal communication skills. (Required proficiency)
- Demonstrated ability to use PCs, Microsoft Office suite (including Word, Excel and Outlook), and general office equipment (i.e. printers, copy machine, FAX machine, etc.). (Required proficiency)
Benefits
- Complies with all policies and standards
- Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.
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