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Revenue Cycle Specialist -
US Remote Nationwide
Essential Job Functions include the following. Other duties may be assigned.
- Review billing documents as assigned for submission to insurance plans and government entities (Medicare, Medicaid, Tricare etc.). Clearing all edits necessary for clean claim submission
- Refer all needed claims to proper management personnel when unable to achieve clean claim status for submission
- Review and understand EOB’s/RA’s (Explanation of Benefits and Remittance Advice documents received from insurance payers and government entities.
- Process all required payments, adjustments to accounts when claim payment is received if required in client or company systems.
- Contact insurance plans and government entities using online systems, email, and phone to resolve unpaid claims
- Provide data to management on trends found with payers in claims adjudication process affecting claims payment
- Provide excellent customer service in keeping with Signature’s legacy both internal and externally
- Assist with process design and redesign as needed for Signature’s client
- Maintain expertise in multiple current client systems
- Maintain up to date knowledge of revenue cycle management, industry trends
- Perform other duties as necessary.
- Acts as an effective team member.
Knowledge & Experience:
- 2+ years health care revenue cycle experience within a physician office, hospital or insurance plan claim processing unit
- Participate in revenue cycle training
- General knowledge of CPT/HCPCS and ICD.10 coding requirements
- Strong attention to detail outstanding written and verbal communication skills
- Computer proficiency including Microsoft Office, Word, Excel and Outlook
- Ability to function effectively in a fast-paced environment
- Personal traits of a high-level commitment, motivation, energy, team orientation, professionalism, trust, personal honesty and integrity, and a demonstration of placing others in a place of high value.
General Areas of Accountability:
The incumbent must conduct business and personal affairs in a manner that is always a credit to the company.
Machines and Equipment:
The incumbent must be able to effectively operate the current computer system, telephone system, and other office machines such as copier and fax machines.
The incumbent must be able to finger, grasp, feel, see, sit, hear, and speak. This position is sedentary in nature with minimal lifting requirements.
The incumbent works in an office environment that is not substantially exposed to adverse environmental conditions such as heat, cold, or extreme noise. Routine periods of being on the phone, sitting and data keying are required.
Remote Eligibility: This position is full-time remote eligible.
The above statements are intended to describe the general nature of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
Job Type: Full-time