CCS Medical

Revenue Cycle Specialist

US-TX-Farmers Branch
ID
2017-2089
Category
Administrative/Clerical
Position Status
Regular Full-Time
Position Schedule
Monday-Friday
Shift
8:00 a.m.- 5:00 p.m.

Overview

Responsible for claim submission and  claim resolution for CCS Medical patients in regards to governmental, commercial insurance companies and patient accounts.  

Responsibilities

  • Works individual portfolio of accounts from CCS Medical billing/collection system
  • Assesses insurance reimbursement for individual supplies to ensure maximum reimbursement
  • Verifies that all appropriate supporting documentation are obtained prior to shipment and/or prior to billing
  • Audits configuration of supplies based on supporting documentation, formulary requirements and manufacturer compatibility
  • Posting payments and / or adjustments to individual accounts
  • Resolving credit balance accounts as needed
  • Identifies problems or improvements within own area, develops resourceful and alternative solutions for work improvement or problem solution
  • Researches and follow up on all correspondence associated with assigned accounts, including EOB’s and documentation letters, and generate correspondence requesting required information, when necessary 
  • Initiates appeals and ensure all required documentation is submitted in the appeals process. Research all denials and follow up as necessary
  • Receives inbound and places outbound calls to/from insurance companies and patients to collect outstanding funds·        
  • Reduces delinquent accounts and achieving maximum collections from all sources
  • Produces reports identifying trends or problem carriers, and identify areas of concern and present ideas to correct or prevent future issues
  • Analyzes and correct accounts receivable problems
  • Documents all activities as completely as possible.
  • Achieves productivity goals based on accounts touched, dollars collected, and aging period
  • Reports any problems to the attention of the Management
  • Must maintain a high degree of confidentiality at all times due to access to sensitive information 

Qualifications

  • High school diploma or GED equivalent.
  • Minimum of two years of medical billing/collections experience necessary.  Must be knowledgeable of reimbursement processes and procedures.
  • Ability to work with other employees and provide assistance as needed.
  • Proficient in basic PC skills.  (MS Office).
  • Organized work habits, accuracy, and proven attention to detail, with strong analytical skills.
  • Ability to work within a team setting and as an individual contributor.
  • Excellent oral and written communication skills.
  • Self-directed with the ability to work with little or no supervision.
  • Flexible and cooperative in fulfilling all obligations
  • Ability to interpret rules and regulations set by Medicare, Medicaid, and Commercial payors.
  • Ability, flexibility, and willingness to learn and grow as the company expands and changes.
  • Ability to recommend and implement changes to processes for efficiency.
  • Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals; ability to write routine reports and correspondence; ability to speak effectively before groups of customers or employees of the organization.                                                             

                   Equal Opportunity Employer/Veterans/Disabled

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