Revenue Cycle Specialist
STRIDE Community Health Center is dedicated to making a lasting impact on the lives of patients and communities. The Revenue Cycle Specialist is responsible for billing and collecting payments for services, ensuring timely and accurate coding, billing, and resolving claim denials.
Responsibilities
- Resolve issues with incomplete and/or inaccurate patient registration
- Verify charges were entered correctly and update as needed
- Work aged receivables utilizing A/R reports/functionality in revenue cycle management (RCM) module
- Review and assess adjudicated claims for timely and proper payment of outstanding balances
- Research, correct and resubmit or reprocess unpaid claims as necessary
- Verify validity of account balance by researching, reviewing, and ensuring accuracy or payment and adjustment posting Review and interpret explanation of benefits (EOB) for denials and reimbursement underpayments
- Research and resolve denials and underpayments with insurance carriers
- Submit third party payor appeals and reconsideration requests in a timely manner
- Meet department and/or organization productivity goals/benchmarks
- Post third party payors(s), government, grant funded and patient payments
- Respond to patient inquiries regarding billings
- Assist other staff as needed to keep department workload current
- Maintain communication with all interested parties regarding patient account issues
- Perform other duties as assigned
Skills
- High school diploma or GED
- Ability to interact positively and build rapport with patients, coworkers and/or external contacts
- Ability to work independently and organize work in a manner that ensures accuracy and efficiency
- Knowledge of medical electronic billing procedures and coding
- Ability to demonstrate the capability to effectively and sensitively respond to the needs and concerns of the full range of STRIDE's diverse patient population
- Customer service skills, including the ability to diffuse upset patients
- Basic math skills required; Basic excel spreadsheet skills and a basic understanding of accounting helpful
- Skill in using a variety of computer software including but not limited to the internet and MS Office products
- Ability to handle sensitive information ethically and responsibly
- Ability to protect the confidentiality of patients, employee and business information
- Must be experienced in working in a fast-paced environment and be able to multi-task and prioritize
- Pharmacy AR experience highly preferred
- CPC Certification preferred
- Bilingual Spanish is preferred
Benefits
- Medical, dental and vision coverage
- Paid time off and paid holidays
- Health Savings account (HSA) and Flexible Spending accounts, including dependent care options.
- 401(K) with matching for eligible employees
- Work-Life balance-No nights, no weekend and no major holidays
- NHSC loan repayment assistance
- Tuition reimbursement and continuing medical education assistance
- Employee Assistance Program (EAP)
- Employee discount programs on top local attractions
- Competitive wages
Company Overview