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Revenue Cycle Specialist

Posted on Apr 11, 2019 by Alive Hospice

Nashville, TN 37203
Health Care
10 Apr 2019
Annual Salary
We are seeking a Revenue Cycle Specialist to join out TEAM!. The Revenue Cycle Specialist Primarily responsible for generating billing, posting payments, and follow-up on claims to ensure timely payment. Also responsible for ICD-10 Coding and Compliance reviews. ESSENTIAL DUTIES AND RESPONSIBILITIES Generates patient claims through EMR billing system. Upload EMC file to clearinghouse as soon after target bill date and errors/holds are clear. Continue review of unsubmitted claims to avoid timely filing to the payers.Responsible for all commercial insurance/Tenncare, hospice per diem, pro fee and palliative care claims, self-pay, Residence and NH Room & Board billing. Review claims prior to submission for compliance with insurance regulations. (all or in part based on assigned duties)Post all non-Medicare payments and balance with daily deposits. Follow up on incorrect, partial payments or unpaid claims. (if applicable to assigned duties)Assist when necessary with any physician visits entry related tasks prior to month end close.Run admission report, assign and enter appropriate ICD-10 codes into EMR based on physician CTI. (if applicable to assigned duties)Using pre-bill CPT audit sample to complete compliance review through physician coding compliance software. Report findings to appropriate Directors and CMO. (if applicable to assigned duties)Report individual finds to the physician for review and resolution of the coding discrepancy. After physician review/approval make coding changes and note in EMR. Report to billing staff when claim can be released. (if applicable to assigned duties)Copy incoming room & board and self-pay checks then forward to AP Clerk for daily deposit. Process credit card payments and refunds. (if applicable to assigned duties)Follow up on outstanding claims per aging report over 60 days. Documenting collection efforts in EMR. Submit appeals when necessary on denied claims.Submit write off requests with documentation after all collection efforts have been exhausted to the Department Director.Notifies Director of any problems with patients' claims, or insurance companies.Initiate projects with insurance provider rep. for specific claim/payment issues. Attend meeting with provider rep. to resolve ongoing and new issues. Maintain documentation to support efforts.Responsible or assists to correct DOD with vital records and Social Security office. (if applicable to assigned duties)Assists other Revenue Cycle Specialist as needed to meet department goals.Other duties may also be assigned. Category: Healthcare , Keywords: Medical Coder

Reference: 692127126

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