Revenue Cycle Specialist II, RCM

United States·Phoenixmid

Revenue Cycle SpecialistHealthcare Non-Clinical

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Quick Summary

Key Responsibilities

Sort incoming mail daily and distributes mail accordingly Scans and saves checks,

Technical Tools

Revenue Cycle SpecialistHealthcare Non-Clinical

The Revenue Cycle Specialist II, RCM is a position that calculates and posts receipts to appropriate accounts, verifies details of transactions; performs billing, posting and collection of claims related to specific payers. In this role, you will report to a Manager of Revenue Cycle Management.

Responsibilities

~2 min read

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Sort incoming mail daily and distributes mail accordingly
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Scans and saves checks, remits and billing documents to correct locations
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Monitors held billing and coordinate resolution of all issues
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Researches, resolves, and prepares claims that have not passed the payer edits daily
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Changes payer and rebills in EMR
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Understands and follows up on claim denials and ability to follow up on denials
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Assists with appeals
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Submits of waiver requests as needed
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Enrolls with payers for EFT/ERA submissions
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Ensures the coordination of claim activities and designated agencies, and the timely reimbursement of receivables
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Reviews and bills all secondary and tertiary insurances to correct charges, bill forms and supporting documentation (EOBs)
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Achieves and maintains net collections and outstanding receivables goals as defined by company objectives
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Identifies trends related to denials/coding and delinquent claims and communicate effectively with client manager for feedback to the client
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Identifies system/payer issues such as rates, codes, set up and coordinate accordingly
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Reports status of accounts and issues to appropriate supervisors and departments – maintains full transparency of accounts at all times
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Follows requirements through the full cycle until accounts are satisfied, including patient collections and appeals
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Documents, processes and coordinates all write offs and adjustments as needed
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Works with contracting team and management to resolve payer issues
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Works with branches for all questions on accounts
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Troubleshoots system issues and work to resolve issues
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Completes Provider enrollments for EFTs/ERAs
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Responsible for ongoing process improvement
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Coordinates coverage and cross training for the team
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Attends regular meetings with teams and management to ensure open communication
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Ongoing training and mentorship with team
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Sets up payers in EMR and tests/tracks setup to ensure accuracy
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Handles critical accounts and projects, coordinating with management, operations, and payers to ensure issues are resolved
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Leads AR meetings with management, branches and staff as required
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Other responsibilities as assigned

Excellent verbal, written and computer communication skills
Able to communicate across all levels of authority within company
Excellent organization, problem solving, and project/time management skills
Able to work with multiple teams within the organization to promote viable, ethical, and cost-effective solutions
Proven track record of successful collections
Able to effectively deal with change
Able to complete projects within specific timetables
Able to successfully interact with people in face-to-face situations as well as by telephone in a professional and effective manner