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Revenue Cycle Specialist I - Financial Clearance, Full Time

Company: Health First
Location: Melbourne
Posted on: November 11, 2019

Job Description:

Description:The Revenue Cycle Specialist I is responsible and accountable for providing?Quality / No Harm, Customer Experience, and Stewardship by ensuring the financial integrity of Health First, Inc/HF Medical Management by performing established financial processes that enable and expedite the billing and collections.? This includes\: Customer Service, billing claims according to Federal/State, and Managed Care rules, regulations and compliance guidelines, patient account research and resolution, insurance verification and benefits determination, identification of reimbursement issues, resolution of credits and issuance of refunds, identification of payment variance invoices, follow up and resolution of denied claims.??Primary AccountabilitiesMonitors Quality Assurance related to job functions per team, i.e. billing, customer service, follow-up, collections, scanning.Knowledge of business office applications and systems.Detects and corrects edits claims prior to submission/transmission of claims, and verifies confirmation received on transmitted claims.Apply coding conventions in order to resolve claim issues and discrepancies with medical necessity.Responds to customer service phone calls, documents actions and findings.Makes calls to responsible parties to determine ability to pay accounts, making financial arrangements when appropriate.Establishes payment arrangements or offers financial assistance, such as charity, Medicaid, government assistance.? Completes assistance application and reviews with established guidelines to approve or disapprove.Process daily electronic payer rejections.Post payments, research credit balances, refunds, and process in a timely manner.Performs follow up, review, and, managing A/R at assigned dunning levels. Researches managed care contracts fee schedules to ensure correct payment and contractuals are taken, effecting account resolution.Qualification:High School Diploma required.One year experience in Healthcare Billing and AR Follow-up, or related field required.Excellent verbal and written communication skills. General knowledge of coding (ICD-9, CPT and HCPCS).General knowledge of medical terminology.General knowledge of accounting principals.Computer experience required. Proficient in standard Microsoft Windows applications.

Keywords: Health First, Melbourne , Revenue Cycle Specialist I - Financial Clearance, Full Time, Other , Melbourne, Florida

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