Senior Medical Revenue Cycle Specialist

23 hours ago

Paranaque City, Calabarzon, Philippines beBeeBillingspecialist Full time $60,000 - $80,000
Job Title:

A skilled Billing and Collections Specialist is sought to manage Third Party billing and collections functions for assigned accounts in the revenue cycle.

This role is responsible for securing payments within defined guidelines for various payers. The position offers flexibility as it can be performed remotely from home.

">Key Responsibilities:
  1. Coordinate accumulation of information with departments; post to resident accounts.
  2. Review charges for accuracy, completeness, consistency, and payer charged.
  3. Prepare and timely issue accurate billing statements using electronic systems.
  4. Monitor submissions on a daily basis to address denials or requests for additional information.
  5. Coordinate with departments and submit ADR information within 10 days of receipt.
Collections Duties:
  1. Follow up on unpaid claims/denials within company standard billing cycle timeframes; determine reasons for denial. Correct claims and re-bill when required.
  2. Document communications and collection attempts, taking follow-up action according to established policies and procedures.
  3. Provide supporting documentation to payer upon request in a timely manner.
  4. Maintain A/R Aging levels for assigned accounts within company guidelines.
  5. Notify supervisors of difficult/problem accounts; residents unwilling or unable to pay balances.
  6. Process claim reclassification to private accounts upon approval from management.
  7. Process bad debts in a timely fashion when claims are determined uncollectable. Document all reasons for uncollectability and efforts in the process.
Additional Tasks:
  1. Apply Third Party payments daily including checks, wire transfers, EFT payments, other bank deposits, cash, and credit card payments. Confirm completeness and accuracy of payment information to the residents' accounts.
  2. Establish good relationships with third-party payers through professional communications.
  3. Efficiently conduct inquiries and analysis for resolution of discrepancies.
Essential Qualifications:
  1. Strong communication, interpersonal, and organizational skills.
  2. Detail orientation.
  3. Ability to manage multiple priorities.
  4. Discretionary judgment.
  5. Ability to work independently and as part of a team.
Language Skills:
  1. Ability to read, write, and speak English proficiently.
Requirements:
  • Two to three years of experience processing skilled nursing medical claims with third parties, including Medicare, Managed Care, and Insurance Companies, with a track record of successful collections.
  • One or more years of experience working in a high-volume, short-term rehab environment.
  • Knowledge of billing and related software preferred and/or experience with similar software.
  • Proficiency with Microsoft Office and ability to learn company IT systems.
Preferred Requirements:
  • MatrixCare/Answers on Demand and Ability experience is a plus.

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