Revenue Cycle Associate - Hospital AR Follow-Up - Revenue Management
This position is responsible for the resolution of outstanding and/or denied claims based on third party claim processing rules within established timelines. The Revenue Cycle Associate reports to the central business office supervisor or manager.
* Meets goals and objectives in assigned area;
* Complies daily with departmental policies and procedures;
* Performs collection activity to ensure proper resolution and reimbursement on claims;
* Provides thorough, courteous, and professional assistance to coworkers and patients;
* Ensures that all claims are billed and collected and meet all government mandated policies for Integrity and Compliance;
* Collaborates with hospital departments in the resolution of accounts;
* Resolves claims processing issues with third party payers and provide all required information timely; involves patients and family members (where necessary) to ensure timely resolution of claims with insurance companies;
* Resubmits clean and accurate claims to insurance companies in a timely and compliant manner;
* Researches, prepares, and submits appeals to insurance companies;
* Details all actions taken on account with clear and concise notes;
* Monitors and recognizes denials and/or issues that may be trends and escalate to supervisor as needed; and
* Maintain strict confidentiality and adhere to all HIPAA guidelines/regulations.
REQUIRED KNOWLEDGE & SKILLS:
* Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices a plus;
* Understands payer guidelines related to effective claim resolution;
* Knowledgeable and proficient with payer websites and other useful resources;
* Knowledge of revenue cycle and/or business office procedures;
* Highly detail oriented and organized;
* Ability to read, understand, and follow oral and written instructions; and
* Ability to establish and maintain effective working relationships and communicate clearly with customers and insurance companies both within and outside of Steward.
Job Status: Full Time
Job Reference #: 54556