Revenue Cycle Specialist II (Medical Billing)

JOB TITLE: Revenue Cycle Specialist II
LOCATION: 2061 Collier Parkway, Land O Lakes, FL 34639
HOURS: Monday thru Friday, 8:00 AM to 5:00 PM
*Hybrid schedule available


POSITION SUMMARY:


Reporting to the Revenue Cycle Manager, the Revenue Cycle Specialist II is responsible for managing accurate, timely completion and submission of multiple third party payers including, but not limited to, Medicare, Medicaid, commercial carriers and self pays as well as collections and accounts receivable functions respectively.

EDUCATION AND QUALIFICATIONS:

• Home health experience a plus
• Two-to-four years of experience in health care billing and collections preferred.
• High school diploma or GED required. Associates degree preferred.
• Billing information systems knowledge
• Working knowledge of home health, hospice and physician billing.
• Knowledge of Microsoft Excel.
• Knowledge of governmental regulations and billing guidelines.
• Demonstrates good communication skills.
• Demonstrated capability to accurately manage detailed information.
• Able to deal tactfully with patients, family members, referral sources and payers.
• Demonstrates autonomy, organization, assertiveness, flexibility and cooperation in performing job responsibilities.

ESSENTIAL JOB RESPONSIBILITIES:

• Ensures reimbursement through efficient, accurate and timely billing process for effective accounts receivable management.
• Work pre-billing report for assigned payers in preparation for month end close.
• Generates claims for submission to payers in accordance with established schedule.
• Utilizes technology to manage clearinghouse and payor accept/reject submissions and reports timely.
• Responsible for accurate posting of cash payments and preparation of cash balancing process.
• Reviews A/R reports and researches unpaid claims. Takes necessary steps to collect unpaid claims and address credit balances. Provide reports to the Patients Account Manager as needed.
• Process correspondence and telephone calls from all payors regarding claims.
• Complete appeals on underpaid claims to the payer.
• Identify, prepare and submit patient account adjustments to Revenue Cycle Manager
• Assist as needed with payer authorizations and verification as required and completed documentation
• Protects the confidentiality of patient and organization information through effective controls and supervision of billing operations.
• The incumbents may be requested to perform job-related tasks other than those stated in this description.

SKILLS AND COMPETENCIES:

• Maintains comprehensive working knowledge of government billing regulations and managed care contract requirements for Hospice billing.
• Adept at utilizing organization electronic billing systems.
• Engage in creative problem solving to understand issues and find solutions.
• Ability to meet deadlines.
• Demonstrates ability to adapt to daily departmental needs as changes occur.
• Ability to coordinate multiple tasks simultaneously.
• Demonstrates ability to utilize Microsoft Office products.
• Ability to maintain all required HIPAA privacy laws as it relates to this position.
• Good communication and interpersonal skills.

Flexible work from home options available.