Revenue Cycle Specialist II; Collections & Special Projects
Job Title: Revenue Cycle Specialist II; Collections & Special Projects
Location: Irvine, CA
Work Mode: 100% Remote
This is a 100% remote position. All necessary equipment to be successful in this position will be provided.
Must Have:-
Revenue cycle experience, collections, insurance verifications, authorizations. Dialysis experience is a huge plus
Schedule:
Full Time hourly- contracted
8-hour day shift; core business hours (40 hours a week)
Monday -Friday
Start times vary by time zone:
PST: 6 am
MST: 7 am
CST: 8 am
EST: 9 am
Job Description:
Would you like to work for a company with Core Values such as TEAM and FUN? Do you want your work to make a difference? Are you looking to build your career in healthcare? Then, join our growing team, which offers abundant opportunities to develop your professional and personal skills, advance your career, and positively impact our patients' lives.
We seeks to grow our Insurance Collections Team concentrating on Special Projects. This role's responsibility is to seek out and maximize reimbursement from various insurance plans by resolving complicated denials, short payments, billing errors, and other claim issues. The ideal candidate is a self-motivated individual that demonstrates strong critical thinking skills and can resolve complex problems with little leadership guidance or intervention. Individuals who excel in this role are ambitious, results-driven, and robust in root cause analysis. In addition, this position requires attention to detail, strong written and verbal communication skills, and the ability to work well as part of a fast-paced team.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Work assigned lists of outstanding claim balances and patient accounts with multifaceted issues across different payers and patients
Identify trends, conduct follow-up, and perform root cause analysis on unpaid and underpaid insurance claims across different payers
Perform actions towards remediation of outstanding balances according to policy and procedure; including but not limited to in-depth research, appeals, rebilling, obtaining insurance authorizations or referrals, correcting coding, calling the payer or clinic, and utilizing payor portals
Resolve issues related to a patient's coordination of benefits (COB), demographic discrepancies, insurance eligibility or authorizations, and referrals as needed
Address patient benefit-related denials, including phone verification of plan requirements, financial risk, as well as other factors that may impact reimbursement
Navigate through various payer systems, provider portals, and internal applications to ensure timely and accurate claim resolution
Regularly calls payers, employers, and patients
Demonstrate ability to build strategic business relationships with internal and external partners (i.e., Billing & Coding Team, Registration Department, Credit Department, clinical teammates, and the payer(s))
Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims
Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and our policies
Meet or exceed team metric expectations for production, quality, and adjustment accuracy
Qualifications:
Required:
Highschool Diploma or equivalent (w/ proof of documentation)
Intermediate knowledge and skills in Microsoft Office tools; Excel, PowerPoint, Word, and Outlook
Experience working in healthcare revenue cycle; emphasis on collections (2+ years)
Ability to confidently place phone calls to payers, clinics and patients
Preferred:
Associate or bachelor s degree
Experience obtaining insurance authorizations and sorting out coordination of benefits --knowledge of retro authorizations and referrals is a plus!