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REMOTE Senior Revenue Cycle Specialist

Company: Paradigm Oral Health
Location: Lincoln
Posted on: April 3, 2024

Job Description:

Roles and ResponsibilitiesThe Revenue Cycle Specialist is well versed and crossed trained in all areas of the revenue cycle and accustomed to working in a high-volume environment. Key Responsibilities include:

  • Performs manual and electronic posting functions for all payors/patient accounts, including cash balancing and reconciliation of bank deposits.
  • Post payment corrections, payment transfers and NSF's.
  • Research and clear unapplied accounts using established identification functions/process.
  • Analyzes and correct insurance account receivable and payment posting ledger and posting errors
  • Reviewing patient accounts to determine and correct any discrepancies; account audits, aging AR, unapplied adjustments, resolving credit balance, unposted payments
  • Ledger accuracy and account integrity
  • Thoroughly research all payor recoupments and identify errors and/or opportunity to dispute and restore loss in revenue. Research and validate patient refunds prior to processing refund to patient and or state for unclaimed funds.
  • Maintains knowledge of insurance rejections/denial processing and appropriately posts information for collection and follow up activity.
  • Research and follow up on all correspondence associated with assigned accounts, including EOB's and documentation letters and generate correspondence requesting required information, when necessary
  • Responsible for all aspects of follow up and collections, including making phone calls, accessing payer websites. Identify issues or trending and provide suggestions for resolution.
  • Accurately and thoroughly documents the pertinent collection activity performed. Review the account information and necessary system applications to determine the next appropriate work activity.
  • Reviews investigate and resolves claims that have been rejected or denied by insurance.
  • Initiates appeals and ensures all required documentation is submitted in the appeal process. Researches all denials and follow up as necessary
  • Verify claims adjudication utilizing the appropriate resources and applications.
  • Receives inbound and places outbound calls to/from insurance companies and patients to collect outstanding funds
  • Answer patient billing questions and act as a resource for patient billing questions.
  • Initiate telephone or letter contact to patients to obtain additional information as needed.
  • Verification of insurance benefits utilizing website, fax and phone. Knowledge of plan types/builds and how to create within the system
  • Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers. Edit claims to meet and satisfy billing compliance guidelines for electronic claim submission.
  • Processing dental clean claims for payment by all insurance companies to ensure appropriate and timely coding, billing and collections
  • Manage and maintain assigned workload, complete reports, and resolve high priority and aged inventory.
  • Responsible for meeting goals and objectives in assigned areas of revenue cycle operations
  • Identifies problems or improvements within own areas, develops resourceful and alternative solutions for work improvement or problem solution
  • Other duties and responsibilities as assigned by leadershipQualifications and Education Requirements Essential Qualifications
    • Prior experience in Dental Office workflows, Revenue Cycle functions to include Scheduling, Registration, Insurance verification, fee schedules, claim submission, charging/coding requirements, insurance AR follow up and payment posting process
    • Must be knowledgeable of reimbursement/compliance process and procedures with all payors
    • Experience with practice management software systems, insurance portals, clearing houses, insurance guidelines, banking reconciliation software, proficient in intermediate PC skills (MS Office-strong excel skills). Strong computer literacy, Excellent Math and problem-solving skills. Data entry and 10-key by touch.
    • Strong interpersonal and organization skills. Ability to work within a team setting and as an individual contributor. Excellent oral and written communication skills
    • Responsible for quality work, meeting deadlines, and adherence to Compliance and Revenue cycle standard operating procedures
    • Organized work habits, accuracy, and proven attention to detail with strong analytical skills PIce96bbbd5086-31181-34009847

Keywords: Paradigm Oral Health, Lincoln , REMOTE Senior Revenue Cycle Specialist, Other , Lincoln, Nebraska

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