Remote Specialist-Revenue Management

Position Summary

This position is 100% remote. We will only consider remote applicants residing in the following US states ? AL, AZ, CT, DE, FL, GA, IN, KS, KY, LA, MD, MI, NC, PA, RI, SC, VA, WV, and WI.

The AR management specialist works with unique department billing/collection functions to assure accounts are managed accurately and timely. Responsibilities will vary based on department need.

Minimum Requirements

Education
? High School Diploma or equivalency

Experience
? 4 years medical office or medical billing in a hospital or physicians billing setting, collections or coding experience.
? Must possess strong knowledge of CPT, HCPCS and ICD-9/10 codes.
? Must be efficient in reading insurance explanation of benefits (EOB) and understanding of remittance and remark codes.
? Good working knowledge of Microsoft Excel
? Good communication skills and the ability to interact well with multiple departments/levels of management

License/Registration/Certifications
? N/A

Preferred Requirements

Preferred Education
? N/A

Preferred Experience
? In depth knowledge of all payer billing and eligibility requirements

Preferred License/Registration/Certifications
? Certified Procedural Coder (CPC) (CPC-H)
? Certified Revenue Cycle Associate (CRCA)
? Certified Medical Insurance Specialist (CMIS)
? Registered Health Information Technician (RHIT)

Core Job Responsibilities
? Responsible for research and resolution of all outstanding patient and insurance credit accounts, any additional A/R management research and account updates required to ensure claims are filed to the appropriate carrier or posted correctly.
? Processing of all refunds or credit reversals in a timely manner as defined within the departmental credit/refund policy/procedures.
? Responsible for all government monthly credit reporting preparation and requirements
? Responsible for accurate charge capture, charge review, claim edits, posting to the AR system and resolution of all charge edits.
? Responsible to handle all denials related to charge capture for improved integrity of charge capture
? Responsible to accurately update patient demographics, insurance registration information, verification of insurance, etc.
? Responsible for the consolidation of duplicate guarantor/patient accounts within the AR management system in an accurate/timely manner.
? Responsible for the review and processing of Accounts Receivables reports to ensure revenue integrity. Reporting trends identified during the analysis.
? Responsible to research and complete a detailed analysis of all payer variances based on our Contract modeling within our AR system.
? Revenue Management Specialist must have the skill set and understanding of payer and government payer contracts/schedules in order to confirm expected reimbursement amounts are correct.
? Work closely with other departments on revenue integrity issues including variance contract build issues, charging issues, A/R type issues and other items as define.
? Responsible for all account financial changes and refiling of those claims to the appropriate payer source.
? Assist with payer/physician credentialing and system table management.
? Responsible for electronic remittance, eligibility and claims agreements to insure the proper processing of electronic transactions, electronic remittance requirements and other payer requirements for billing.
? Responsible for the processing of all vendor claim updates, returns and resubmissions for payment.
? Other duties as assigned.

Location: Spartanburg Regional Healthcare System ?Business Services
Schedule: Full-Time, Days