Sr Revenue Cycle Specialist (Special Projects & Collections)

Title: Sr. Revenue Cycle Specialist: Collections, Special ProjectsLocation: 100% RemoteDuration: 5+ Month with Extension

JOB DESCRIPTION:We seeks to grow our Senior Insurance Collections Team concentrating on Special Projects. This role's responsibility is to seek out and maximize reimbursement from various insurance plans by resolving complicated denials, short payments, billing errors, and other claim issues. The ideal candidate is a self-motivated individual that demonstrates strong critical thinking skills and can resolve complex problems with little leadership guidance or intervention. Individuals who excel in this role are ambitious, results-driven, and robust in root cause analysis. In addition, this position requires attention to detail, strong written and verbal communication skills, and the ability to work well as part of a fast-paced team. This is a 100% remote position. All necessary equipment and training to be successful in this position will be provided.

ESSENTIAL DUTIES AND RESPONSIBILITIES:Work assigned lists of outstanding claim balances and patient accounts with multifaceted issues across different payers and patientsIdentify trends, conduct follow-up, and perform root cause analysis on unpaid and underpaid insurance claims across different payersPerform actions towards remediation of outstanding balances according to policy and procedure; including but not limited to in-depth research, appeals, rebilling, obtaining insurance authorizations or referrals, correcting coding, calling the payer or clinic, and utilizing payor portalsResolve issues related to a patient's coordination of benefits (COB), demographic discrepancies, insurance eligibility or authorizations, and referrals as neededAddress patient benefit-related denials, including phone verification of plan requirements, financial risk, as well as other factors that may impact reimbursementNavigate through various payer systems, provider portals, and internal *** applications to ensure timely and accurate claim resolutionRegularly calls payers, employers, and patientsDemonstrate ability to build strategic business relationships with internal and external partners (i.e., Billing & Coding Team, Registration Department, Credit Department, clinical teammates, and the payer(s))Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claimsMaintain confidentiality of all company and patient information in accordance with HIPAA regulations and *** policies

SKILLS: Proficiency in Microsoft Office tools, including Excel, PowerPoint, Word, and Outlook (required)Experience working in healthcare revenue cycle; emphasis on collections (2+ years) (required)Experience obtaining insurance authorizations and sorting out coordination of benefits (preferred) Knowledge of retro authorizations and referrals is a plus!Ability to confidently place phone calls to payers, clinics and patients

EDUCATION: Highschool Diploma or equivalent (required)Associates or Bachelor's degree (preferred)