Position Summary:
The Revenue Cycle Specialist will provide essential support to the Revenue Cycle Division by ensuring the resolution and reconciliation of aged patient account receivables. The role involves working closely with Revenue Cycle Leadership to innovate processes and provide staff support, helping foster a collaborative team environment that adds value to internal and external customers. This position focuses on follow-up and account resolution, including communication with payors, patients, clients, and reimbursement vendors.
Key Responsibilities:
Account Resolution & Follow-up: Analyze aged open patient accounts, including technical and at-risk denials, and work towards resolving outstanding balances. Collection Activities: Communicate with payors, patients, clients, and other reimbursement vendors via phone, letters, or portal messages to follow up on unpaid, denied, or rejected claims.
Patient Financial Clearance: Review patient eligibility and third-party reimbursement benefits, assist with filling coverage gaps, and handle inquiries from patients regarding financial matters.
Denials & Payments Management: Identify and resolve underpayments, overpayments, and denial trends, and ensure timely resolution of patient accounts in accordance with state and federal guidelines.
Documentation & Reporting: Document all follow-up efforts in the appropriate EMR system and ensure all correspondence is accurate and up to date.
Credit Balances & Refunds: Review and process credit balances and determine the appropriate refunds.
Patient Assistance Programs: Assist patients in enrolling in coverage assistance programs (e.g., Sliding Fee Scale, Grants, Medicaid, Marketplace) to reduce financial barriers to care.
Benefits Counseling: Review patient's third-party coverage benefits and counsel them on their insurance benefits and payment options.
Selling Points:
Opportunity to be part of the early stages of a growing School of Medicine and contribute to the development of new service lines.
Gain visibility and exposure to top leadership within the Revenue Cycle Management department as it continues to expand.
A dynamic and collaborative work environment offering potential for career growth and development.