Healthcare Revenue Cycle Specialist

Our company specializes in recruiting and managing remote staff for dynamic healthcare facilities. We connect clients with highly qualified professionals, offering tailored services to meet their unique business needs.

The Opportunity

A Billing & Collections Specialist position is available, responsible for all Third Party billing and collections functions for assigned accounts in the revenue cycle. This role involves managing billing processes to secure payments within defined guidelines for Medicare, Medicaid, Managed Care, Co-insurance companies, and Long Term Care Insurance Companies.

This is a remote position that offers flexibility and work-life balance.

Key Responsibilities

• Coordinate accumulation of information with various departments; post to resident accounts.
• Review charges for accuracy, completeness, consistency, and payers charged.
• Prepare and timely issue accurate billing statements to the correct payer using electronic systems provided.
• Monitor all submissions on a daily basis to address any denials or requests for additional information (ADRs).
• Coordinate with all departments and submit ADR information within 10 days of receipt of request.

Additional Responsibilities

• Follow up on unpaid claims/denials within company standard billing cycle timeframes; determine reasons for denial. Correct claims and re-bill when required.
• Document all communications and collection attempts, taking follow-up action in accordance with established policies and procedures.
• Provide needed supporting documentation to payer upon request in a timely manner.
• Maintain A/R Aging levels for assigned accounts within company guidelines.
• Notify supervisors of difficult/problem accounts; residents unwilling or unable to pay balances.
• Process claim reclassification to private accounts upon approval from management.
• Process bad debts in a timely fashion when claims are determined to be uncollectable. Document all reasons for uncollectability and efforts in the process.

Cash Application

• 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.

Customer Service

• Establish good relationships with all third-party payers with professional communications.
• Efficiently conduct inquiries and analysis for resolution of discrepancies.

General Requirements

• Adhere to the highest practical standards in policies and procedures.
• Participate in and maintain current status on all training and education required by the company.
• Communicate effectively with all members of the staff and business partners.
• Provide feedback to others for continuous quality improvement of the entire organization.
• Openly accept feedback from others for continuous quality improvement of the entire organization.
• Escalate issues when there is an appearance that business standards of quality are not present.
• Comply with all rules and regulations of the organization, including HIPAA and safety.
• Perform other duties as assigned.

Requirements/SpecificationsEducation and Experience:Required:

• 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:

• MatrixCare/Answers on Demand and Ability experience is a plus.

Essential Qualifications:

• Strong communication, interpersonal, and organizational skills.
• Detail orientation.
• Ability to manage multiple priorities.
• Discretionary judgment.
• Ability to work independently and as part of a team.

Language Skills

• Ability to read, write, and speak English proficiently.

Benefits

We offer flexible scheduling, a remote work environment, and opportunities for growth and development. You will collaborate with an international team while contributing to our growing business from the comfort of your home.

You will need to have some essential tools – a reliable computer and noise-canceling headset, a second monitor for enhanced productivity, and a stable internet connection. You'll also be required to have a backup internet connection, ensuring that you're well-equipped to complete your work seamlessly.

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