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Sr. Revenue Cycle Specialist : Medicare Collections

Sr. Revenue Cycle Specialist : Medicare Collections

TranzealSan Francisco, CA, United States
21 hours ago
Job type
  • Full-time
Job description

Required Qualifications :

  • High school diploma or equivalent (GED)
  • Proficiency in Microsoft office tools such as Outlook, Word, PowerPoint, Excel, and OneNote
  • Excellent and demonstrated written and verbal communication skills
  • Computer competency; typing, basic computer troubleshooting, and navigation
  • Ability to problem solve and critically think root cause analysis

Preferred Qualifications :

  • Healthcare experience; insurance or revenue cycle is a plus!
  • Insurance claim collections experience
  • Client is hiring Sr. Revenue Cycle Specialists who excel in Medicare Collections for our Revenue Operations Department. Successful individuals in this role are highly ambitious, results-driven, and strong in root cause analysis. This position requires a high level of attention to detail, critical thinking, and the ability to work well as part of a fast-paced team. In addition, the ideal candidate has a high level of multitasking abilities, strong mathematical and analytical skills, and is driven by moving metrics to achieve success.

    Specialists in this role will contact Medicare Administrative Contractors (MACs) to reconcile outstanding accounts receivable (debit balances), research and resolve problem accounts, and request adjustments or rebills on claims.

    ESSENTIAL DUTIES AND RESPONSIBILITIES :

  • Research, initiate follow-up, and resolve all unpaid or underpaid system debit balances on Medicare insurance claims; includes but is not limited to remit review, calling payer(s) and clinics, rebilling, navigating payer portals, and taking adjustments
  • Uses critical thinking, problem-solving and analytical skills to determine the root cause of our underpayment and follow appropriate policy and procedure to remediate
  • Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of Medicare claims
  • Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims
  • Ad hoc monthly reporting of outstanding debit balances and trends
  • Stay current on communication relating to healthcare reimbursement and regulatory changes
  • Develop and maintain positive working relationships with clinical personnel, teammates, and payer representatives
  • Works well under pressure in a fast-paced environment and meets expectations of deadlines, and carries out assignments to completion while maintaining a positive attitude
  • Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
  • Consistent and punctual attendance as scheduled is an essential responsibility of this position
  • Skills :

  • 3+ years of Medicare Experience (required)
  • 2+ years of experience with generic accounting, transactions, or medical billing systems (preferred)
  • Healthcare and medical billing / collections / denial remediation experience (required)
  • Intermediate computer proficiency in Microsoft Office tools including Excel, PowerPoint and Outlook (preferred)
  • Education :

  • Highschool Diploma or equivalent (required)
  • Associates or Bachelor's degree (preferred)
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    Revenue Cycle Specialist • San Francisco, CA, United States

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