Revenue Cycle Specialist Ancillary

Florida Orthopaedic Institute; Florida; Hybrid; USD 54,443,000 - 57,308,000; Full time

Job summary

Orthopaedic Solutions Management is seeking a Revenue Cycle Specialist to ensure timely collection of accounts receivable for advanced imaging services. You will research claim denials, monitor pre-bill edits, and collaborate with teams across the business office to secure maximum reimbursement.

The role requires 2–4 years in physician office billing with CMS 1500 familiarity, strong communication skills, and proficiency in Microsoft Office.

Qualifications

• High School Diploma or general education degree
• 2 – 4 years ofphysician office billing and denial management experience required
• Basic Understanding of ICD10, CPT/ HCPCS
• Ability to read and interpret explanation of benefits (EOBs)
• Knowledge of Medical Assistance, Medicare Part B and commercial insurance products
• Familiar with CMS 1500
• Basic understanding of medical terminology and anatomy.
• Athena experience strongly preferred
• Excellent communication skills both written and verbal
• Must be a self-starter that is detail oriented and capable of multi-tasking
• Requires comprehensive knowledge of computer skills including Microsoft Office Suite

Responsibilities

• Performing collection activities, such as status calls to ensure timely reimbursement, appeals and account review.
• Ensuring appropriate information is submitted to insurance companies in order to expedite payment.
• Take appropriate follow up actions on accounts to ensure claims are paid on the first follow-up call or appeal.
• Determine that appropriate information is submitted to insurance companies in order to expedite payment.
• Following up on assigned cases from within the organization
• Reviewing pre-bill claim holds to verify that the claim goes out clean the first time
• Composing appeals to insurance carriers for denied claims
• Handle incoming calls for information request from insurance companies within 24 hours.
• Assisting Financial Counselors when patients have questions regarding claims
• Corrects accounts that are billed to incorrect insurance companies.
• Ensures authorizations are attached to claims
• Comply with quantity and quality expectations as provided by management
• All other duties as assigned

Job description

• Pay or shift range: $19 USD to $20 USD
  The estimated range is the budgeted amount for this position. Final offers are based on various factors, including skill set, experience, location, qualifications and other job-related reasons.

Description

Position Summary: Under direct supervision of the Revenue Cycle Ancillary Manager, this position is responsible for assuring timely collection of accounts receivable, monitoring account activity and providing adequate follow up to ensure maximum reimbursement is received for advanced imaging services. The ideal candidate would have a strong understanding of medical claims billing.

• Research and resolve claims denials using the appropriate resources
• Check that pre-bill claims are passing internal edits in a timely fashion
• Monitor that all denied claims are corrected or appealed
• Collaborate with other teams within the business office
• Provide appropriate feedback to management.

Qualifications:

• High School Diploma or general education degree
• 2 – 4 years ofphysician office billing and denial management experience required
• Basic Understanding of ICD10, CPT/ HCPCS
• Ability to read and interpret explanation of benefits (EOBs)
• Knowledge of Medical Assistance, Medicare Part B and commercial insurance products
• Familiar with CMS 1500
• Basic understanding of medical terminology and anatomy.
• Athena experience strongly preferred
• Excellent communication skills both written and verbal
• Must be a self-starter that is detail oriented and capable of multi-tasking
• Requires comprehensive knowledge of computer skills including Microsoft Office Suite

Key Responsibilities:

• Performing collection activities, such as status calls to ensure timely reimbursement, appeals and account review.
• Ensuring appropriate information is submitted to insurance companies in order to expedite payment.
• Take appropriate follow up actions on accounts to ensure claims are paid on the first follow-up call or appeal.
• Determine that appropriate information is submitted to insurance companies in order to expedite payment.
• Following up on assigned cases from within the organization
• Reviewing pre-bill claim holds to verify that the claim goes out clean the first time
• Composing appeals to insurance carriers for denied claims
• Handle incoming calls for information request from insurance companies within 24 hours.
• Assisting Financial Counselors when patients have questions regarding claims
• Corrects accounts that are billed to incorrect insurance companies.
• Ensures authorizations are attached to claims
• Comply with quantity and quality expectations as provided by management
• All other duties as assigned

Orthopaedic Solutions Management is a Drug Free Workplace

We are committed to maintaining a safe, healthy, and productive work environment. As part of this commitment, we operate as a drug-free workplace. All candidates will be required to undergo pre-employment drug screening and/or be subject to random drug testing in accordance with applicable laws and company policy.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.