Revenue Cycle Management Professional
5 days ago
Job Description
- Responsibilities: Develop curriculum, training syllabus, and course modules related to Medical Billing (US Health Insurance, Claims Process, Denials & Appeals, Revenue Cycle Management)
- Develop Basic Account Navigation Workflow of Billing System for both HP and PB (Epic, Athena) and other system tools (Encoder Pro, CCI Edit) used by the department.
- Develops Denials Process workflow for Common Denials (Duplicate, Timely Filing, No Prior-Auth, Medical Necessity, etc.)
- Develops a guideline for common Payer Policies for the Top US Health Insurance Payers (Aetna, BCBS, Humana, UHC, Cigna, etc.)
- Update and improve existing training and process modules.
- Coordinate with forensic quality department to identify areas for process improvement and produce materials for claim edits, denials workflow, systems & process training from client.
- Develops and produces materials for Medical Billing, Denials, Systems and Process exercises and qualifying examinations.
- Updates weekly deck (performance and attendance for training meeting).
- Participates in weekly training meetings with the upper management.
- Collaborates with billing operations managers, supervisors, and quality to resolve issues that impact internal and external customers.
- Develops and conducts Call/Phone Handling Training for the new hires and existing forensic billers.
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