Job Summary:
The Revenue Cycle Specialist reports to the Assistant Director of Revenue Cycle Billing and will interface with Finance, Operations and Managed Care Organization payers to maximize revenues. The position will be responsible for the full cycle management of encounter based claims directly submitted to Medicaid and several Managed Care Plans. The Revenue Cycle Specialist will assist in coordinating with all related parties in order to submit timely and accurate claims and support the timely follow up and resubmission of denied claims with the objective of maintaining a minimal denial rate for the agency.
Essential Job Functions:
- Timely and accurate submission of encounter based claims.
- Timely review of remittances advices to ensure proper payments and agreed rates are received.
- Trigger follow-up with Programs for any incomplete claims data necessary for accurate billing submission.
- Reconcile claim denial reports on daily/weekly basis, prepare appeals and communicate with program management to prevent future billing issues.
- Work with agency stakeholders to ensure the continuous follow-up with Medicaid and Managed Care Payers on open payments and billing issues.
- Prepare and reconcile monthly billing reports against general ledger.
- Creating open items reports for explanation to management and for discussion, awareness and follow up with Program.
- Liaise with Program and other inter-agency departments regarding billings, collections and compliance matters.
- Work proactively with the billing team, to identify opportunities for productivity improvements
- Assists in preparing for internal and external audits with requested documentation
- Perform routine and ad-hoc financial analyses, and other duties as requested.
Qualifications:
- Associate's Degree required; Bachelor's degree in finance or accounting preferred
- Basic computer skills, Microsoft Excel, Outlook and Word, and accounting knowledge
- Minimum two years' experience billing Medicaid, Managed Care and Commercial plans required
- Aptitude for being proactive in a fast paced environment and managing competing priorities.
- Excellent communication, interpersonal and decision making skills
- Knowledge of Fund EZ, Change Health Care, eMedNY and e-Paces
Salary:
$55K - $60K
Please Note :
www.bankofmontserrat.ms is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, www.bankofmontserrat.ms provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.