Revenue Cycle Specialsit-Collector FT

LAS CRUCES, NM Full Time
POSTED ON 4/12/2024

ESSENTIALS DUTIES AND RESPONSIBILITIES:

 

·         Timely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims for all payers including self-pay to obtain maximum reimbursement.

·         Manage daily work queue to prioritize high dollar claim balances.

·         Review & work incoming insurance and patient correspondence including refund requests.

·         Send appeals when appropriate or provide the requested medical documentation.

·         Ability to review medical documentation to justify medical necessity.

·         Take incoming patient phone calls to resolve inquiries, billing issues, or outstanding balances.

·         Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents.

·         Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCD’s) for claim resolution.

·         Negotiate payment amounts for procedures with Third Party Administrators for out of network providers.

·         Recommend an adjustment when applicable or recommend a refund for overpayments to insurance carriers or patients, providing the appropriate documentation.

Required Skills:

 

·                      2 years of revenue cycle 

  • Ability to read and interpret insurance explanations of benefits and managed care contracts.
  • Must communicate effectively, both verbally and in writing, with internal and external clients.
  • Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines.
  • Knowledge or experience working with a variety of health care insurance payers is preferred.
  • High School Diploma or equivalent.





Required Experience:

General knowledge of the healthcare industry insurance/EOB payment process

 

Salary.com Estimation for Revenue Cycle Specialsit-Collector FT in LAS CRUCES, NM
$39,642 to $50,430
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