Revenue Cycle Specialist in Decatur, GA at Prestige Staffing

Date Posted: 10/23/2019

Job Snapshot

  • Employee Type:
    Contractor
  • Location:
    Decatur, GA
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    10/23/2019

Job Description

JobID: 24182

Prestige Staffing is looking for an experienced Revenue Cycle Specialist who is very versed with managing document management processes (lock box correspondence).

Benefits:

Normal business hours Monday - Friday

Great location

Discounted / Free parking

Great choices for full time benefits

JOB DESCRIPTION:

Great knowledge of all aspects of the Revenue Cycle through Final Claims Resolution.

This position updates demographic and insurance information for accuracy on all patients.

Collects and follows up on all accounts assigned prior to, during or after admission and discharge.

Communicates hospital's findings back to the Physician, Nursing Team and Patient as appropriate.

Identifies patients who require financial counseling intervention; provides information regarding resources for patients who need financial help after discharge and/or during collections and follow up activities.

Verifies, researches and completes all paperwork and forms to bill all types of claims for reimbursement. Which may include insurance company, drug replacement, and/or Pharmaceutical programs to help patients with their out of pocket expenses for drugs.

Serves as a patient advocate during the cycle of the account. Assist with departmental workflow as needed.

Identifies and notifies leadership of issues and initiates appropriate action for resolution.

Communicates and provides feedback as needed to section leaders, hospitals CFO, Managed Care, Finance and other leaders.

Maintains thorough understanding of insurance, payment reimbursement, account reconciliation, referrals, authorizations, and account follow-up to secure reimbursement of claims.

Provides support to leadership facilitating quality improvement by reporting problems, concerns, and opportunities for increased revenue and decreased denials.

Assists in training and development of new staff members.

Must be able to review and operationalize contracts as it relates to billing and reimbursement of claims, including infusion, transplant and other complex accounts.

Understanding and maintaining knowledge of standard for care of specific transplant population and the phases of donors and recipients.

Provides liaison and educational services in support of standards.

Identifies and resolves financial issues relating to all patients.

Problem solving skills are required as the applicant must be able to use various tools, analyze the situation, research data and resolve and/or formulate a decision.

Works closely with Management in formulating and implementing departmental objectives toward enhancing the work flow of the department.

This position requires heavy phone and computer usage, and a detailed knowledge of applicable EMRs, patient accounts, payer, and financial tools.

Education sessions and insurance payor forums should be attended as appropriate.

Set up internal and external meetings with staff and payor representatives on a quarterly or as needed basis to discuss concerns relative to billing and proper reimbursement.

Will assist in keeping documentation current with payor updates and trends as they occur.

Required to review, analyze and understand the Managed Care Contracts and various aspects of patient care to maximize reimbursement. 

Able to work independently.

Excellent verbal, written, analytical and interpersonal communication skills.

Organizational skills are also very important.

QUALIFICATONS:

Bachelors Degree with three years of revenue cycle experience; OR any combination of equivalent education and healthcare experience.

Certified Patient Accounts Representative (CPAR) and/or Certified Patient Financial Counselor (CFC) required.

Experience analyzing data and completing quality audits

Project Management skills would be a huge plus

Able to pass a drug test including tobacco as well as a criminal background

Able to write well (will be tested)

Uses professional grammar and diction when speaking and writing emails

Able to use MS Excel

Interested and qualified candidates apply today!