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Biller / Revenue Cycle Management Specialist

KPH Healthcare Services • Full-time • Maumee, OH, US • 1w ago

Overview

Job Summary: The Revenue Cycle Management Specialist is to support the process of the company's billing function.

Responsibilities

Job Duties:

Report any misconduct, suspicious or unethical activities to the Compliance
Ensure verification of current coverage with third party payers and obtain authorizations as
Assist in the preparation and submission of claims for payment from third party payers, and invoices for patient co-payments.
Support the resolution of billing issues such as claim resubmissions to all payers, changes in coverage, and claims
Communicate as required with patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries about
Review and approve refunds of third-party payer and patient overpayments.
Assist in record keeping so that all information is accurate and complete and manage the flow of up-to date information between billing department and other parts of the company, such as the accounts receivable, accounts payable and customer service
Ensure the implementation of processes to measure, assess, and improve the performance of the billing department activities of the company.
Review and suggest changes to billing department policies and procedures as needed.
Ensure ongoing compliance with all laws and regulations; ensure that the department meets or exceeds accreditation standards; and implement "best practices" in all departmental \
Participate in surveys conducted by authorized inspection
Participate in the company's Performance Improvement program as requested by the Performance Improvement
Participate in company committees when
Participate in in-service education programs provided by the company.
Pursue continuing education programs appropriate to job
Perform other duties as assigned by
Responsible for completing all mandatory and regulatory training programs
Perform other duties as assigned

Qualifications

Educational Requirements:

High school diploma or GED

Experience:

One to three years of experience in Home Nursing/Services or related organization

Credential/Licensure Required:

Must be a licensed driver with an automobile that is insured in accordance with state and agency requirements and is in good working order

Special Conditions of Employment:

Drug test
Initial and continuous exclusion and sanction/disciplinary monitoring
Any and all additional eligibility requirements based on the specific position

Job Skill Requirements:

Complies with accepted professional standards and practice
Has satisfactory references from current employers and professional peers
Has excellent observation and communication skills
Is self-directed with the ability to work with little supervision
Is flexible and cooperative in fulfilling obligations

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