CCS Medical

  • Revenue Cycle Specialist

    Job Location US-FL-Clearwater
    ID
    2018-2179
    Category
    Administrative/Clerical
    Position Status
    Regular Full-Time
    Position Schedule
    Monday-Friday
    Shift
    9:00 am - 6:00 pm
  • 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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