Revenue Cycle Specialist

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Job description

Overview:
Are you looking for a purposeful career that will make a difference in the patient community? At CCS, our approach to at-home patient care is redefining chronic care management. We are seeking individuals that will thrive in a patient-centric dynamic environment. If you are an attentive listener, fast-thinker, and problem-solver, with the ability to relate to different people, you are a match for CCS.

As a Revenue Cycle Specialist you will be responsible for claim submission and claim resolution for CCS Medical patients regarding governmental, commercial insurance companies and patient accounts

Alaska, California, Colorado, Delaware, Hawaii, Idaho, Maine, Montana, Nevada, New Hampshire, New York, North Dakota, Rhode Island, South Dakota, Vermont, Washington, Wyoming; residents are not eligible.

Responsibilities:
Works individual portfolio of accounts from CCS Medical billing/collection system

Assesses insurance reimbursement for individual supplies to ensure maximum reimbursement

Verifies that all appropriate supporting documentation are obtained prior to shipment and/or prior to billing

Audits configuration of supplies based on supporting documentation, formulary requirements and manufacturer compatibility

Posting payments and / or adjustments to individual accounts

Resolving credit balance accounts as needed

Identifies problems or improvements within own area, develops resourceful and alternative solutions for work improvement or problem solution

Researches and follow up on all correspondence associated with assigned accounts, including EOB's and documentation letters, and generate correspondence requesting required information, when necessary

Initiates appeals and ensure all required documentation is submitted in the appeals process. Research all denials and follow up as necessary

Receives inbound and places outbound calls to/from insurance companies and patients to collect outstanding funds

Reduces delinquent accounts and achieving maximum collections from all sources

Produces reports identifying trends or problem carriers, and identify areas of concern and present ideas to correct or prevent future issues

Analyzes and correct accounts receivable problems

Documents all activities as completely as possible.

Achieves productivity goals based on accounts touched, dollars collected, and aging period

Reports any problems to the attention of the Management

Must maintain a high degree of confidentiality at all times due to access to sensitive information

Qualifications:
High school diploma or GED equivalent.

Minimum of two years of medical billing/collections experience necessary. Must be knowledgeable of reimbursement processes and procedures.

Ability to work with other employees and provide assistance as needed.

Proficient in basic PC skills. (MS Office).

Organized work habits, accuracy, and proven attention to detail, with strong analytical skills.

Ability to work within a team setting and as an individual contributor.

Excellent oral and written communication skills.

Self-directed with the ability to work with little or no supervision.

Flexible and cooperative in fulfilling all obligations

Ability to interpret rules and regulations set by Medicare, Medicaid, and Commercial payors.

Ability, flexibility, and willingness to learn and grow as the company expands and changes.

Ability to recommend and implement changes to processes for efficiency.

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals; ability to write routine reports and correspondence; ability to speak effectively before groups of customers or employees of the organization.

Values:
Values

Certainty-The lives of the individuals we serve depend on our ability to execute. We commit to doing this every day.

Use appropriate methods and a flexible interpersonal style to help build a cohesive and collaborative team based on a foundation of trust and transparency. Deliver what you commit to.

Compassion-We understand the burdens of patients and their loved ones and channel this into a relentless pursuit of customer satisfaction in every part of our business.

Ensure that the patient is the driving force behind business decisions, implementing service practices that meet needs of both the patient and the organization. Treat other the way you want to be treated.

Advancement-We are endlessly looking for ways to progress and become more innovative in all things we do.

Encourage innovative approaches for addressing opportunities and facilitating change, driving cross-functional alignment to accomplish goals. Speak the truth.

CCS Medical and EEOC/AA employer. M/F/D/V

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