The Revenue Cycle Specialist is responsible for billing, collections, claims resolution and payment posting for multiple government, commercial, and private payers for a behavioral health outpatient clinic and other programs.
Essential Duties and Functions
Charge and Claim Processing -
Confirm that all services provided have been entered
Appropriately process all services to be billed
Timely file all claims -primary and secondary
Confirm successful transmission to payors and timely resolve any transmission errors
Timely communicate un-billable claims to mitigate timely filing denials
Claim Resolution -
Follow-up with payers to resolve all rejections, denials, re-submissions, and appeals.
Communicate with insurance companies, program staff and other internal stakeholders to settle billing issues and resolve open claims
Work open claims systematically giving priority to aged claims to resolve balances in a timely manner
Respond to inquiries or follow up on issues and provide information to resolve outstanding balances
Partner with program personal, ensure compliance with RHD Billing requirements and guidelines
Create and provide reports to analyze billing and accounts receivable
Initiate the write-off of claims, where applicable
Ensure payments and adjustments are properly applied and that payments reconcile to the EOB’s received by payers
Retrieve payment files from various websites for payment processing
Process payments received from multiple insurance plans,third parties and patients
Ensure deductibles, coinsurance, copay and denials are properly posted
Perform payment research and investigation as needed
Reconciling Unapplied Accounts
Complete all other duties as assigned
Associate Degree in a business-related field or equivalent work experience
Prior work experience with billing, claims follow-up, and payment posting for healthcare or mental health in a high volume Medical Insurance Billing setting
Proficiency in Microsoft Excel and Outlook
Must be detail-oriented and able to juggle multiple assignments
Experience with Netsmart Avatar application is a plus
Resources for Human Development is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, age, religion, gender, gender identity, sexual orientation, national origin, genetic
information, veteran, or disability status.
Resources for Human Development is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, age, religion, gender, gender identity, sexual orientation, national origin, genetic information, veteran, or disability status.