CCS Medical

Revenue Cycle Specialist

US-FL-Clearwater
ID
2017-2091
Category
Administrative/Clerical
Position Status
Regular Full-Time
Position Schedule
Monday-Friday
Shift
9:00 - 6:00

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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