Title Revenue Cycle Specialist, Fiscal Services
Job Information

REVENUE CYCLE SPECIALIST, Fiscal Services

REPORTING/COORDINATING RELATIONSHIP: Director of Finance

SUPERVISORY RESPONSIBILITIES: None

PRIMARY RESPONSIBILITIES:

1. Denial Resolution: researching, resolving, and resubmitting denied claims; taking timely and routine action to collect unpaid claims; and interpreting various forms of explanations of benefits (EOBs) from insurance carriers
2. Customer Service: providing quality assistance to Pennyroyal Health Systems (PHS) clients/patients to resolve any and all billing-related questions; and ensuring proper demographic and insurance information for those patients served
3. Cash Applications: entering client/patient and insurance payments, contractual allowances, denials, correspondence, and other adjustments into the PHS’s practice management system; balancing and reconciling posting batches; and participating in month-end close
4. Other duties as assigned/required.

MINIMUM QUALIFICATIONS:
Associate’s degree or medical billing certification preferred. 3+ years of experience working in a community mental health center, behavioral health organization, or multispecialty group practice. 3+ years of experience working with a behavioral health/medical office/hospital accounts receivable system. Extensive knowledge of insurance payer reimbursement, collection practices, and accounts receivable follow-up. Demonstrates overall knowledge of claims processing for various insurances, including private and governed. Comprehensive knowledge of ICD-10, CPT, and HCPCS coding. Moderate to advanced computer skills, including Microsoft Windows programs. Moderate to advanced keyboard skills with high accuracy rate. Ability to communicate effectively in written and spoken English. Demonstrates effective communication and interpersonal skills with a diverse population. Ability to organize and prioritize workload to manage multiple tasks and meet deadlines. The ability to work with individuals at all organizational levels, particularly peers, team members, other departments, clients/patients, and the community is required. Demonstrates the ability to carry out assignments independently, work from procedures, and exercise good judgment. Demonstrates the ability to maintain the confidentiality of all records. Proficiency with Netsmart software. Must pass a Criminal Record Check.

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