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Revenue Cycle Specialist : Medicare Collections (RSI)

Revenue Cycle Specialist : Medicare Collections (RSI)

C&L GroupDenver, CO, US
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Would you like to work for a company with Core Values such as TEAM and FUN? Do you want your work to make a difference? Are you looking to build your career in healthcare? Then, join our growing team, which offers abundant opportunities to develop your professional and personal skills, advance your career, and positively impact our patients' lives.

  • is hiring Revenue Cycle Specialists for our Medicare Patient Accounts team in our Revenue Operations Department. Successful individuals in this role are highly ambitious, results-driven, and like root cause analysis. This position requires a high level of attention to detail, critical thinking, and the ability to work well as part of a fast-paced team. In addition, the ideal candidate has a high level of multitasking abilities, strong mathematical and analytical skills, and is driven by moving metrics to achieve success.

Specialists in this role will conduct collections activities which will entail contacting Medicare Administrative Contractors (MACs) to reconcile outstanding accounts receivable (debit balances), research and resolve problem accounts, and request rebills or adjustments on claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES :

  • Research, initiate follow-up, and resolve all unpaid or underpaid system debit balances on Medicare insurance claims; Actions include but are not limited to remit and EOB review, calling payer(s) and clinics, rebilling claims, navigating payer portals, and taking adjustments in the billing system
  • Uses critical thinking, problem-solving and analytical skills to determine the root cause of our underpayments and follow appropriate documented policy and procedure to remediate
  • Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of Medicare claims
  • Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims
  • Stay current on communication relating to healthcare reimbursement and regulatory changes
  • Develop and maintain positive working relationships with clinical personnel, teammates, and payer representatives
  • Works well under pressure in a fast-paced environment, meets expectations of deadlines, and carries out assignments to completion while maintaining a positive attitude
  • Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and
  • policies
  • Consistent and punctual attendance as scheduled is an essential responsibility of this position
  • Qualifications : Required :

  • High school diploma or equivalent (GED)
  • Proficiency in Microsoft office tools such as Outlook, Word, PowerPoint, Excel, and OneNote
  • Excellent and demonstrated written and verbal communication skills
  • Computer competency; typing, basic computer troubleshooting, and navigation
  • Ability to problem solve and critically think root cause analysis
  • Preferred Qualifications :

  • Healthcare experience; insurance or revenue cycle is a plus!
  • Insurance claim collections experience
  • Here is what you can expect when you join our Village :

  • A "community first, company second; " a culture based on Core Values that really matter
  • Clinical outcomes consistently ranked above the national average
  • Award-winning education and training across multiple career paths to help you reach your potential
  • Performance-based rewards based on stellar individual and team contributions
  • A comprehensive benefits package designed to enhance your health, your financial well-being and your future
  • Dedication, above all, to caring for patients suffering from chronic kidney failure across the nation
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    Revenue Cycle Specialist • Denver, CO, US

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