What are the responsibilities and job description for the RCM QA Specialist II position at Envision Healthcare?
Overview
Envision Physician Services is a multispecialty physician group and practice management company. Established in 1953, our organization provides anesthesia, emergency medicine, hospital medicine, radiology, primary/urgent care, surgical services, and women’s and children’s health services to hospitals and health systems nationwide. Sheridan Healthcare, EmCare, Reimbursement Technologies and Emergency Medical Associates have recently joined forces to form Envision Physician Services. As one organization, we now provide a greater scope of service than any other national physician group. Our collective experience from hundreds of local, customized engagements, culture of continuous lean process improvement, and team of experts in the business of healthcare enable us to better solve complex problems and consistently give healthcare organizations confidence in our execution. Our combined organization serves more than 780 healthcare facilities in 48 states and the District of Columbia.
If you are looking for a stable, fast-paced, growing company in the healthcare industry that is committed to innovation, excellence and integrity, then this may be a great next step in the advancement of your career.
We currently have an exciting opportunity available for an experienced RCM Accounts Receivable Representative III.
Responsibilities
The RCM Accounts Receivable Representative Specialist III is responsible for the overall team flow and performance of collections as well as any special RCM projects assigned.
- Recommends improvements in insurance processing, which will reduce reimbursement turnaround time
- Keeps Manager and/or Supervisor abreast of any changes in reimbursement that may affect initial billing procedures
- Trains assigned personnel and evaluates performance
- Initiates and answers pertinent correspondence
- Monitors and completes adjustments to ensure correct reimbursement as instructed by Manager/Supervisor
- Maintains confidentiality of all information concerning patients, employees and/or company business
- Researches all assigned contracted and/or non-contracted carrier accounts to insure the proper payment of claims through reports, spreadsheets and special projects as deemed necessary
- Researches denied and improperly processed claims by contacting assigned carriers to insure proper processing of said claims
- Identifies and corrects any claim processing (data entry, verification, coding and/or posting) errors
- Monitors and reviews payment posting processes
- Monitors the customer service queue on a daily basis, and schedules adequate phone coverage
- Assists employees on all contracted and/or non-contracted carrier questions
- Provides daily/weekly status emails of projects
- Participates in weekly meetings as requested
- Other duties as assigned
Qualifications
- High School Diploma or General Education Degree (GED) and 3 or more years of related experience
- Good organizational skills
- Communicate and work well in a team environment
- Meet established production and quality goals/metrics
- Follow up in a timely manner on open items
- Able to effectively prioritize work on a daily basis
- Microsoft Office Suite
- Healthcare Billing System
If you are ready to join an exciting, progressive company and have a strong work ethic, join our team of experts! We offer a highly competitive salary and a comprehensive benefits package.
Envision Physician Services uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify.
Envision Physician Services is an Equal Opportunity Employer.
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