Revenue Cycle Specialist III, RCM

The Revenue Cycle Specialist III is a position that calculates and posts receipts to appropriate accounts, verifies details of transactions; performs billing, posting and collection of claims related to specific payers. In this role, you will report to the Account Receivable Manager, RCM.

Duties / Responsibilities :

• Monitor held billing and coordinate resolution of related issues to ensure timely claim submission
• Review, research, and correct claims that fail payer edits; update payer information and resubmit claims within the EMR system as needed
• Understand and actively follow up on outstanding accounts receivable to minimize aging
• Work all assigned and denied claims promptly and accurately
• Assist in preparing and submitting appeals and reconsiderations to payers
• Collaborate with internal teams (billing, authorizations, clinical, etc.) to resolve billing and collections issues
• Communicate with payers to obtain claim status and resolve outstanding balances
• Maintain accurate documentation of collection activities and provide updates and reports on collection efforts as requested
• Assist with special projects, audits, or process improvement initiatives as assigned
• Identifies trends related to denials / coding and delinquent claims and communicate effectively with client manager for feedback to the client
• Identifies system / payer issues such as rates, codes, set up and coordinate accordingly
• Reports status of accounts and issues to appropriate supervisors and departments - always maintains full transparency of accounts
• Follows requirements through the full cycle until accounts are satisfied, including patient collections and appeals
• Handles critical accounts and projects, coordinating with management, operations, and payers to ensure issues are resolved
• Documents, processes and coordinates all write offs and adjustments as needed
• Works with contracting team and management to resolve payer issues
• Works with branches for all questions on accounts
• Attends regular meetings with teams and management to ensure open communication
• Ongoing training and mentorship with team
• Assists in AR meetings with management, branches and staff as required
• Perform other duties as assigned

Required Skills / Abilities / Knowledge :

Education / Experience / Licenses / Certifications :

Physical Requirements :

"You are not required to disclose information about physical or mental limitations that you believe will not interfere with your ability to do the job. However, you should disclose any physical or mental impairment for which special arrangements or accommodations are needed to enable you to perform the essential functions of the job. Your description of any impairment and suggestions for reasonable accommodations will be considered in providing reasonable accommodations."

FLSA Status : Non-Exempt

EEO Status : Administrative Support Workers

Benefits + Perks of Joining the Team Select Family

Pay Range : $18.00 - $24.00 / hour

Team Select Home Care reserves the right to change the above job description and qualifications without notice. Team Select Home Care will not discriminate against you on the basis of race, color, religion, national origin, sex, sexual preference, disability, political belief, veteran status, age, or any other status protected by law. Team Select Home Care is an employment-at-will employer.