Revenue Cycle Management Specialists (Billing, Payment Posting and Accounts Receivable) - Full-time

Goodside Health is seeking Revenue Cycle Management Specialists with expertise and dedication to play a vital role in ensuring the financial health of our organization. Our RCM team members are instrumental in managing the intricate process of revenue generation, from the initial patient encounter to the final payment collection.

At the heart of our RCM department lies the commitment to efficiency, accuracy, and excellence. Our RCM team collaborates with various stakeholders, including clinicians, administrative staff, and insurance providers, to optimize revenue streams while maintaining compliance with regulatory standards.

Our RCM team is a key contributor to the organization's success. Attention to detail and the ability to adapt to evolving industry trends are essential in navigating the complexities of healthcare reimbursement. The team's efforts impact the organization's ability to provide high quality care to our patients while sustaining the financial viability of our organization.

ABOUT GOODSIDE HEALTH

Our pediatric urgent care line of business, Urgent Care for Kids, was founded in 2011 and operates thirteen clinic locations throughout Texas. We launched our novel SchoolMed offering in 2019 with the aim to advance the delivery of pediatric care. Today, SchoolMed proudly serves more than 1.1 million eligible students and their campus communities though our telehealth and well care programs.

At Goodside Health, we are driven to provide excellent patient care and customer service. Our purpose is to close the gaps in children's healthcare through innovation and execution. The ideal candidate is initiative-taking, innovative, and passionate about our purpose as well as our core values of Passion, Humility, Adaptability, Nurture, and Experience.

Join us for a career where you can grow professionally in a nurturing environment that values innovation and a collaborative approach. We offer competitive benefits, opportunities for professional development, and a dynamic workplace culture aligned with our core values.

Available positions: Billing Specialists, Payment Posting Specialists, and Accounts Receivable Specialists.

Requirements for ALL Positions

• High school diploma or equivalent

• Competency in Microsoft Office 365 (especially Excel) and electronic medical record (EMR) software

• Ability to read, understand, and interpret explanation of benefits (EOB) documents

• Ability to define challenges, analyze problems, and suggest solutions in a proactive and positive manner

• Ability to effectively communicate with patients, insurance companies, and team members within organization using excellent both verbal and written communication skills

• Ability to manage and prioritize multiple tasks through excellent time management and organizational skills

• High attention to detail in fast paced and dynamic environment

• Ability to adapt to change quickly and rebound well

• Ability to handle repetitive tasks

• Regular and reliable attendance is a core requirement of this position as it affects quality and organizational cash flow

ESSENTIAL FUNCTIONS

• Create accurate billing by reviewing CPT, ICD-10 and Modifier guidelines by insurance

• Audit patient demographics and insurance information prior to billing

• Generate and send electronic claims

• Manage and correct rejected claims

• Review prior months to be sure all billing has been sent out

REQUIRED SKILLS AND ABILITIES

• Proficient in HMO, PPO, and governmental insurances

• Understanding of CMS-1500 forms, Clearinghouse claim submission, CPT, ICD-10, and HCPCS

• Proficiency in healthcare terminology and medical procedure coding

EXPERIENCE

• 1 – 2 years' experience in medical insurance billing and/or collections.

ESSENTIAL FUNCTIONS

• Reviewing Electronic Remittance Advice for proper payment

• Daily cash reporting and posting using Excel and company software programs

• Reconcile bank deposits to ERA & Credit card deposits received

• Scanning EOB's into system

• Applying patient credits/insurance denials/zero payers to patient accounts

• Preparing Refund Requests

• Posting Account adjustments

• Daily Balancing

• Month End reporting

• Other duties as required

REQUIRED SKILLS AND ABILITIES

• Ability to search within insurance websites such as Availity, TMHP, Optum

EDUCATION & EXPERIENCE

• 1-2 years insurance payment posting with multiple payers.

• Must have experience in posting from Bank Lockbox

• Experience in Microsoft Excel with sorting/filtering with large sets of data to optimize and streamline workflow

• Experience working with eMDs/Epic/Centricity is a plus

ESSENTIAL FUNCTIONS

• Accurate processing of accounts receivable transactions including payments and adjustments

• Determining appropriate reimbursement on all assigned insurance claims

• Regularly calling insurance plans on work list to update claims statuses

• Reviewing patient accounts to determine necessary follow-up action including filing appeals on claim denials and underpayments, corrections, and/or adjustments

• Reaching out to patients and clinics to edit or add necessary claims information

• Responding to insurance company claim inquiries

REQUIRED SKILLS AND ABILITIES

• Expertise in querying within insurance websites including Availity, TMHP, and Optum

• Proficiency in healthcare terminology and medical procedure coding

EDUCATION AND EXPERIENCE

• At least 2 years of experience in insurance payment posting with multiple payors

• Working experience with Medicare/Medicaid

• Experience working with eMDs, Epic, and/or Centricity is a plus

COMPENSATION & BENEFITS

The base hourly pay rate range for these positions is $18/hour to $24/hour.

At Goodside Health, compensation is determined based on factors that may include geographic location, skills, education, and experience. In addition to these factors, we believe in the importance of pay equity and consider the internal equity of our current team members as a part of any offer.

The salary range listed is just one component of Goodside Health's total compensation and rewards programs, which also include:

• Competitive compensation & incomparable company culture

• Certain revenue-generating positions may be eligible for incentive compensation

• Medical, Dental, Vision

• Basic Life, Voluntary Life, Short-Term and Long-Term Disability

• Accident, Hospital Indemnity, Critical Illness, Legal and ID Theft Insurance

• Pet Insurance

• Employee Assistance Program

• Corporate Discount Program

• Team Member Recognition Program

• Swag Store

• 401k Retirement Savings Plan

• Paid Time Off (PTO) & Holidays

• Free In-Clinic & Telemedicine Visits for Team Members & Dependents

EQUAL OPPORTUNITY STATEMENT

Goodside Health sincerely embraces diversity and equal opportunity. We are committed to building a team that represents a variety of backgrounds, perspectives, and skills. We believe that diverse teams make the strongest teams, and we encourage people from all backgrounds to apply.

Compensation details: 18-24 Hourly Wage

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