Revenue Cycle Specialist Job – Norwood, OH

Position Summary:

Revenue Cycle Specialist consist of: (1) handling a very high volume of detailed data processing; (2) working under tight performance guidelines; (3) focusing on details and be able to multi-task while working in a fast-paced collection agency environment; (4) must be able to quickly learn multiple computer systems and understand abbreviations, medical and legal terms (5) billing insurance companies for all clinic and physician bills; (6) pursuing collection of all claims until payment is made by insurance companies; (7) performing other work associated with the billing process.(8). Present a friendly and customer service environment to all patients, staff and vendors.

Essential Job Duties:

• Prepares and submits physician and clinic claims to third-party insurance carriers either electronically or by hard copy billing.
• Secures needed medical documentation required or requested by third party insurances.
• Follows up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains.
• Processes rejections by either making accounts private and generating a letter of rejection to patient or correcting any billing error and resubmitting claims to third-party insurance carriers.
• Works with physician or medical record staff to ensure that correct diagnosis/procedures are reported to third party insurance carriers.
• Ensure proper documentation and charge entry of patient charges
• Keeps updated on all billing and insurance changes for third-party insurance carriers.
• Monitors claims for missing information and authorization/control numbers.
• Maintains confidentiality of all information.
• Completes work within authorized time to assure compliance with departmental standards.
• Keeps updated on all third-party billing requirements and changes for insurance types within the area of responsibility.
• Demonstrates knowledge of, and supports, clinic mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.
• Maintains third-party billing logs.
• Performs other duties as required.
• Assure documentation is in compliance with regulatory agency requirements and best clinical practices.
• Adhere to the organization’s policy, procedures and professional code of ethics
• Self-motivated and self-directed; able to work without supervision.
• Proficient computer skills, Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel); working knowledge of billing software a plus.