REMOTE Senior Revenue Cycle Specialist
Company: Paradigm Oral Health
Location: Lincoln
Posted on: October 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
PIc71eeeaab857-37248-35705389
Keywords: Paradigm Oral Health, Omaha , REMOTE Senior Revenue Cycle Specialist, Other , Lincoln, Nebraska
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