Job Description
Revenue Cycle Lead - USA Clinics Group - Northbrook, IL - work from home job
Company: USA Clinics Group
Job description: The Revenue Cycle Lead, reporting to the Revenue Cycle Manager, acts as a subject matter expert for all revenue cycle functions and activities. This position is responsible for ensuring compliance with third party payor requirements as well as all applicable state/federal laws and regulations.
Only candidates able to commute to the jobs on-site location (Northbrook, IL) Monday through Friday 5 days a week will be considered. Remote work is not an option.
Responsibilities
Β Acts as subject matter expert for assigned revenue cycle areas, ensuring optimal revenue collection and patient satisfaction with the billing experience and ensuring compliance
Β Performs RCA (Root Cause Analysis) to resolve problems affecting the revenue cycle and develop solutions to implement.
Β Contacts insurance regarding claim status, denials, underpayments, and recoupments
Β Read and understand insurance eligibility and benefits
Β Research & resolve outstanding claim issues and patterns
Β Submit Appeals for Denied Claims
Β Submit Medical Records and other documentation requests to insurance
Β Ability to work on 40+ denied claims per day on the phone and provider portals
Β Ensures compliance with USAVC policies and procedures, health plan requirements, and federal and state laws and regulations
Β Additional duties as assigned
Requirements
Β Bachelor's Degree plus 3 or more year's previous experience in medical collections, or an equivalent of experience and education, required
Β Minimum of 2 years prior revenue cycle experience required
Β Experience with Aetna, BCBS, UHC, Medicare, and Medicaid denials required
Β Experience with multi state insurance denial collecting a preferred
Β Familiar with provider portal eligibility and claim tools. Example: Availity, Navinet required
Β Ability to read and understand insurance remittance including denial and remark codes required
Β Ability to understand the remittance denial codes and get claims reprocessed required
Β Strong personality and willingness to rebuttal with insurance claims representatives to overturn denials
Β Exceptional customer service and phone etiquette
Β Thorough understanding of physician billing practices and procedures, including knowledge of state, local and federal laws
Β Strong knowledge of reimbursement rules and methodologies for both physician and ambulatory surgery billing
Β Strong knowledge of Microsoft Excel (VLOOKUP and Pivot Tables)
Β Only candidates able to commute to the jobs on-site location (Northbrook, IL) Monday through Friday 5 days a week will be considered. Remote work is not an option.
Benefits
Β Health
Β Dental
Β Vision
Β 401K & match
Β PTO
Revenue Cycle Lead - USA Clinics Group - Northbrook, IL - work from home job
Expected salary: $60000 per year
Location: Northbrook, IL
Revenue Cycle Lead - USA Clinics Group - Northbrook, IL - work from home job
Job date: Sat, 26 Aug 2023 22:04:57 GMT
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Revenue Cycle Lead - USA Clinics Group - Northbrook, IL - work from home job
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