RCM Billing and Collections Specialist

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Job description

FHE Health is a healthcare institution that delivers quality, medically integrated personalized treatment for those suffering from Behavioral Health Disorders. We are in Deerfield Beach, Florida, near Fort Lauderdale. We are proud to ethically serve the South Florida community as well as the nation with our healthcare services. We specialize in addictive disorders and other behavioral health disorders such as depression, anxiety, and traumatic disorders. We employ a team of highly qualified, compassionate individuals who share in the desire to serve this vulnerable population. We provide innovative treatment by treating not just the mind and the behaviors, but by treating the BRAIN itself through our cutting-edge neuro-rehabilitative services.

What Are We Looking for?

We are looking for an RCM Billing and Collections Specialist. Must be experienced in Physicians Group Collections. Reports to the Director of IRCM.

Benefits of the RCM Collections Specialist

As a full time, RCM Billing and Collections Specialist you will be offered the following benefit options:

• Medical
• Dental
• Vision
• Supplemental Life
• Disability
• 401k
• Personal PTO
• Vacation Time
• Employee Assistance Program

Requirements of the RCM Billing and Collections Specialist:

Under the direction of the Director of IRCM, the RCM Billing and Collections Specialist will be responsible for collections under the Physicians Group.

This position is ideal for candidates seeking a full time-time position. M-F

Qualifications/Skills

• High School or GED Diploma
• Current CPR Certification or must be obtained
• Crisis Prevention Intervention (CPI) Training or must be obtained
• Minimum of 2+ years of experience in healthcare billing, collections for addiction/behavioral health treatment center
• Knowledge of insurance guidelines
• Competent use of computer systems, software, and 10 key calculators.
• Familiarity with CPT, ICD-10 Coding, and ASAM criteria
• Effective communication abilities for phone contacts with insurance payers to resolve issues
• Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
• Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion
• Problem-solving skills to research and resolve discrepancies, denials, appeals, collections. A calm manner and patience working with either patients or insurers during this process
• CPC, CSS, CAA, COC,CBP, CMC, CBCS certification preferred, not required.

Essential Job Function of the RCM Collections Specialist

• Prepare, key, and review claims prior to reconciliation
• Processes claim corrections identified from the reconciliation
• Experience with coding, CPT/HCPC, Revenue, and Diagnosis codes
• Experience with 1500 HCFA and UB04 claim forms
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing
• Through billing software, review claim rejections and correct errors, and rebill claims
• Following up on unpaid claims within the standard collection cycle timeframe
• Checking each insurance payment for accuracy and compliance with contract and usual and customary charges
• Calling insurance companies regarding any discrepancy in payments and underpayments
• Calling insurance companies for payment on open/unpaid claims
• Identifying and billing secondary or tertiary insurances
• Reviewing accounts with balances to identify next steps, including balances needing to be set as "collections" for balance due patient
• Researching and appealing denied claims
• Answering patient or insurance telephone inquiries pertaining to assigned accounts
• Transferring Patient collection calls to the designated department

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