BARROW BRAIN AND SPINEJOB DESCRIPTIONREVENUE CYCLE SPECIALISTJOB TITLE: Revenue Cycle SpecialistDEPARTMENT: Business OfficeREPORTS TO: Revenue Cycle Manager FLSA STATUS: Non-ExemptJOB SUMMARY: Responsible for making sure that BBS is reimbursed correctly and in a timely manner from all insurance companies, reviewing and posting office and surgical charges, and responsible for interacting with the patients to collect outstanding balances.JOB DUTIES & RESPONSIBILITIES TO INCLUDE: · Identifies delinquent accounts, aging period and payment sources by contacting third party payers· Researches insurance credit balances and regularly writes up requests for refunds· Responsible for appealing incorrectly processed claims, and if necessary, making the appropriate adjustment· Responsible for refiling primary paper claims & secondary claims within a timely manner· Assists secretaries and patients with insurance issues and questions· Handles incoming correspondence from insurance companies· Scans documents when necessary, into the practice management system· Negotiates payments with non-contracted insurance payers· Attends specific insurance training seminars/webinars as required· Participates in appeals hearings as requested by specific insurance companies· Maintains privacy, confidentiality, and security of patient, client, staff, and organizational data.    

• Posts office      and ancillary procedure charges to computer system
• Balances      charge totals when batch is completed
• Contacts      physician’s immediate staff for corrections needed in order to process the      charge. If not received in a timely manner follows up with them again      staff until all corrected information is received
• Keeps      supervisor informed of any recurring problems regarding charge batches
• Monitors      surgery schedule in order to pull off any completed surgeries not received      that can be posted and sent out to insurance
• Follows up on      all holds and make sure that all tickets put in the status of hold are      cleared out within 30 days, and if not brings this to the attention of the      Revenue Cycle Director
• Makes sure      that all tickets that are in a status approved failed due to lacking      demographic information are fixed within a timely manor
• Works missing      fee ticket report and contacts appropriate personal so that all missing      fee tickets can be located 
• Is      responsible for making sure that all information is entered on account so      that a clean claim will go out
• Works with      patients to obtain payment for services and provides alternative payment      plans to resolve outstanding debt.
• Contacts      patients regarding COB information. 
• Answers main      business office telephone lines and processes calls
• Accurately      updates financial and demographic information into the appropriate system
• Interacts      with collection agencies, bankruptcy and deceased patient accounts as      required
• Processes patient      receipts per BBS standards
• Identify and      process patient refunds a needed 

PERFORMANCE REQUIREMENTS:

• Demonstrates      acute awareness of insurance company contracts 
• Displays      ability to analyze payment denials and compose letters of appeal
• Possess      ability and desire for cross training in all areas of the Business Office
• Reports to      work regularly without undue tardiness
• Maintains      positive attitude and demonstrates the utmost in professionalism
• Dresses      appropriately and professionally 
• Works      independently, without supervision, completes work accurately and in a      timely manner
• Maintains      effective working relationships with physicians, administration and other      staff members
• Demonstrates      good communication skills with other staff members as well as patients,      insurance companies, outside physician offices, and physicians
• Possesses      ability to identify areas of account problems and explain effectively to      patients
• Attends      staff meetings and participates in special committees as required
• Other      duties and assignments as necessary, overtime as required

EDUCATION & EXPERIENCE:

· Two years prior experience in a private practice or hospital billing/business office preferred· Insurance billing experience utilizing CPT, ICD-10 and modifier coding preferred· High school diploma or G.E.D required· Athena One EMR and Centricity experience preferred  

PERFORMANCE REQUIREMENTS:

• Demonstrates acute awareness of insurance company contracts 
• Displays ability to analyze payment denials and compose letters of appeal
• Possess ability and desire for cross training in all areas of the Business Office
• Reports to work regularly without undue tardiness
• Maintains positive attitude and demonstrates the utmost in professionalism
• Dresses appropriately and professionally 
• Works independently, without supervision, completes work accurately and in a timely manner
• Maintains effective working relationships with physicians, administration and other staff members
• Demonstrates good communication skills with other staff members as well as patients, insurance companies, outside physician offices, and physicians
• Possesses ability to identify areas of account problems and explain effectively to patients
• Attends staff meetings and participates in special committees as required
• Other duties and assignments as necessary, overtime as required