Remote Revenue Cycle Specialist – Work-From-Home

St. Elizabeth Physicians; Erlanger (KY); Remote; USD 60,000 - 75,000; Full time

Benefits offered by this job

Work from home after training

Paid time off

Medical, dental, and vision insurance

403b with match

Growth opportunities

Job summary

St. Elizabeth Physicians is seeking a Revenue Cycle Specialist- Follow up for the Primary Care Department. The role reports to the Revenue Cycle Manager/Administrator of Revenue and focuses on timely responses to patient calls, A/R work, EOBs, and accurate data updates in the practice management system.

The position handles claims filing, refunds, adjustments, and coordination with payors. The role requires CPC for trainers and a high school diploma, with non-exempt, regular full-time hours and

Qualifications

• Knowledge of medical insurance, managed care plans, CPT, ICD9 and ICD10 codes.
• Ability to read and understand Explanations of Benefits from all insurance companies.
• Knowledge of FDCPA and Bankruptcy.
• Detailed and thorough work on special projects as assigned.

Responsibilities

• Provide information and resolve issues from patients/family members and insurance companies.
• Work Adjustment, Zero Pay, and A/R aging report and correspondence daily.
• Follow-up with the insurance company as needed regarding payment/non-payment of claims.
• Refil[e] claims to secondary insurance when claims have not been received or processed.
• Submit activity log, audit journals, EOBs, and Account Follow-Up Logs daily.
• Communicate effectively with payors, patients/family members, physicians, support staff, coworkers, and management.
• Answer incoming calls professionally and within 3 rings; return voicemails within 1 business day.
• Update patient demographics and profile information.
• Enter Financial Hardship information and apply adjustments in PM system.
• Responsible for NSF postings, letters, follow-up, tracking checks and adjustments.
• File claims to various insurance companies.
• Edit and entry of all claims (office, hospital, nursing home).
• Post payments, medical records and disability payments.
• Balance and document payments; adhere to processes.
• Respond to refund requests from insurance companies promptly.
• Analyze overpayments and determine refunds due.
• Keep an accurate refunds log for month-end reporting.
• Audit statements and process weekly reports.
• Send and track patient statements and collection letters.
• Set up payment plans or arrangements.
• Work all correspondence/C15/C11 reports.
• Refer accounts to collection agencies.
• Post agency payments and verify commissions.
• Perform claims follow-up.
• Send medical records requests and note accounts.
• Coordinate pulling, copying and mailing of EOBs for primary/secondary refiles.
• Log bad addresses and notify offices.
• Manage Working Claim Edit (Reg) WQ and Working Errors in Quadax.
• Track envelopes.
• Other duties as assigned.

Skills

Medical insurance knowledge

Understanding EOBs

FDCPA knowledge

Attention to detail

Education

High School Diploma/G.E.D.

CPC certification

Job description

St. Elizabeth Physicians is seeking a Revenue Cycle Specialist- Follow up for the Primary Care Department. The role reports to the Revenue Cycle Manager/Administrator of Revenue and focuses on timely responses to patient calls, A/R work, EOBs, and accurate data updates in the practice management system.

The position handles claims filing, refunds, adjustments, and coordination with payors. The role requires CPC for trainers and a high school diploma, with non-exempt, regular full-time hours and