Revenue Cycle Specialist

Job description

Job Overview: The Revenue Cycle Specialist is responsible for responding to and resolving a variety of account, billing and payment issues from patients and insurance companies. Reviews the medical record and abstracted information as necessary to provide insurance claim information or to resolve incoming correspondence regarding patient services. Reviews accounts to determine correct adjustments have been applied, payments posted and refunds distributed. Uses excellent customer service and interpersonal skills when interacting with patients and insurance companies, following confidentiality guidelines. Makes appropriate decisions that require individual and/or team analysis – utilizing good problem-solving skills. Interprets, applies and communicates federal regulations, insurance contracts and hospital-wide policies regarding the medical and financial aspects of patient care to ensure optimal third-party payment for the patient and the hospital. Responsibilities/Duties: Education/Experience: - Process complete and accurate claims in a timely and efficient manner, assuring that the payer guidelines are followed, facilitating compliance and maximum reimbursement. - Resolve system b...