Specialist, Revenue Cycle-Float Pool

Job Title: Specialist, Revenue Cycle - Float

Company: Acclara

Department: A/R Float Pool & Anc Support

• Tegria - A/R Float Pool & Anc Support

Leader: Manager, Revenue Cycle Services

FLSA Status: Hourly/Non-Exempt

Work Location: This position is remote within the U.S.

Travel: Remote

Compensation: $15.00 - $32.32

OVERVIEW

The Revenue Cycle Specialist-Float serves as a resource to support with special projects, backlogs, and other needs within the Revenue Cycle operations team to include: Data & Claims Quality, Customer Service, Payment Posting, Insurance Follow-up, Contract & Credentialing, Medical Coding, and Admin Support.

Responsibilities include:

• Retrieve EOB’s from payer sites for clients that have an EFT deposit with no electronic remit and add them to the payment intake tool for posting.
• Review and interpret payment information from the EOB (explanation of benefits) to accurately apply payment and adjustment when necessary.
• Professionally resolve inbound customer service calls from patients in the call queue
• Review and resolve accounts in Global Interface Engine. Action may include but not limited to updating insurance, authorization, creating accounts
• Other duties as assigned
• Interface with clients to obtain applicable documentation required to credential providers and facilities with contracted health plans and load into the credentialing database as well as in the Council for Affordable Quality Healthcare (CAQH) database.
• Work with multiple payors, across multiple states and various information systems including Practice Vision and EPIC.
• Review and interpret over payment requests and determine appropriate next steps.
• Interpret and understand basic accounts receivable (A/R) metrics as well as necessary steps to review and act on unpaid A/R
• Prepare and mail claims to the insurance carriers and or upload documents to other billing platform.
• Assist with building health plan rates and fee schedules into the contracting database.
• Research and resolve coding related denials. Search for information in cases where the coding is complex or unusual. Correct claim scrubber errors and update workflow logs.
• Assist the Revenue Cycle team with contracting and credentialing concerns that impact the claims process.
• Review, respond to, and complete priority follow-up requests
• Download generated appeal letters from insurance follow-up through a billing shared application and attach any required documentation, such as clinical reports, EOB’s, etc.
• Review outstanding patient balances related to payment plans, no statement holds, and special handling accounts and take appropriate action(s).

QUALIFICATIONS

• Desire and ability to work collaboratively with team members and communicate effectively with all levels of staff
• Technical aptitude and proven track record of learning new systems
• 10 key, data entry skills and proficiency in Microsoft Excel and Word
• Understanding of payer policies
• Ability to maintain a high level of detail and confidentiality
• 4+ years in at least three of the following areas: medical billing, claim clearinghouse errors, medical coding, payment posting experience, payor enrollment, insurance follow up or call center/customer service.
• Proven ability to analyze data, perform multiple tasks and work independently in a busy work environment.
• Follow through, time-management and prioritization imperative
• Ability to interpret explanation of benefits (EOB)
• Ability to Interact with providers and clients in a professional and pleasant manner
• Ability to identify problems and issues and provide solutions
• Critical-thinking, reasoning, problem-solving skills and adaptability to change
• Strong written and verbal communication skills

Physical Requirements:

The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Listed below are the physical requirements required while performing the duties of this job.

• The employee must have the specific vision ability to complete close vision requirements due to computer work
• The employee is required to be able to complete light to moderate lifting
• The employee is regularly required to: stand; sit; talk; hear; use hands and fingers to operate a computer and telephone keyboard; and reach, stoop and/or kneel to install computer equipment

Our Commitment to Diversity, Equity, and Inclusion

We welcome and respect the variety of experiences, viewpoints, and cultural backgrounds that everyone brings to our workplace. Acclara makes every effort to promote a workplace where leaders model inclusive behaviors and individuals feel respected, valued, and empowered. Together, we promote and sustain an inclusive workplace where people feel a sense of belonging.