Revenue Management Specialist

Job Title
Revenue Management Specialist
Job ID
27394726
Location
Matthews,  NC 28105
Other Location
Description

PURPOSE:

Responsible for complete Revenue Cycle management, contractual modifications, and ensuring operation billing compliance for the purpose of maximizing collected revenue and maintaining accurate records.

FUNCTIONS:

  • Validate, approve, and bill all eligible services within timeframes established by supervisor
  • Identify collections issues and resolve outstanding receivables to increase cash collections
  • Post payments, balance bill, and create credits/adjustments as needed
  • Send out monthly client statements and communicate with clients to help ensuring balance payment
  • Create payment plans for large client balances that help ensure payment while maximizing revenue
  • Help create, modify, and implement billing and collections policies within the IRM department
  • Verify and determine eligibility for clients whose claims are rejected or denied
  • In coordination with supervisor, modify insurance and third-party contracts to ensure maximum rates and accurate records
  • Work with supervisor to establish and implement new billing procedures for new programs and services
  • Generate accurate recurring and ad-hoc financial reports
  • Maintain updated payer rates, licenses, and other dynamic data within the billing system
  • Keep up to date with NCCI Edits, medical coding terminology, billing compliance requirements, and payer procedure changes
  • Keep detailed and accurate notations on all issues revolving around payers, providers, and claims within the billing system
  • Performs any other related duties or special assignments as assigned by direct supervisor

Position Specifications and/or Education:

Position requires strong computer skills and understanding of electronic health records systems. Requires analytical skills to help quickly identify issues and come up with creative solutions if necessary. Candidate must possess knowledge of medical coding terminology and NCCI and HIPAA best practices.  Must have a working knowledge of commercial and managed care payers. Strong organizational and project management skills with a solution-oriented mindset. Ability to work independently and as part of a team. Finally, must have strong communication skills and the ability to coordinate, update, and escalate tasks as needed.

Associates degree in medical billing and coding or similar major or 3 years experience in a medical billing position required. Previous experience working with revenue for a mental health organization preferred.      

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