Revenue Cycle Associate

Position Title: Revenue Cycle Associate (Non-Exempt)

Reports to: Director of Revenue Cycle and Patient Accounts

Position Summary: Under the supervision of the Revenue Cycle and Patient Account Director, the Revenue Cycle Associate is responsible to e nsure and reconcile billing encounters – claim and statement processing, corrective coding, payment posting, accounts receivable/denial follow-up.

Job Duties and Responsibilities:

• Prepare, review, transmit 827P/837I and process primary and secondary claims for Institutional (UB04) & Professional (HCFA) billing as well as printing paper claims for timely submission.
• Adjusting encounters and correct patient statements according to our Sliding Scale policy.
• Monitor, research and resolve unpaid, rejected and denied claims
• Initiate and answer correspondence for claims resolution with insurance carriers.
• Import and Export EDI / ERA files from multiple sources and verify all payments posted and adjustments have been applied according to policy.
• Maintain files and documentation thoroughly and accurately, in accordance with company policy and accepted accounting practices
• Assist with projects and other duties as assigned

Education/License/Certificate Required:

The qualified candidate is required to have a high school diploma or equivalent, three years’ Billing and Coding (Medical and/or Dental) FQHC/CHC experience. Candidate should have a solid understanding of Medicaid, Medicare and other insurance benefits, Insurance portal ePaces, Connex, Navinet and other provider portals. Electronic claims submissions and excellent communication and organizational skills. Experience billing for a Federally Qualified Health Center (FQHC) or Community Health Center (CHC) environment.

Knowledge, skills, and abilities required:

• Knowledge of Medicaid – Wraparound / 4028, Medicare and other insurance guidelines, including Commercial / Managed Care / Advantage /HMO /PPO etc.
• Knowledge of facility based billing/reimbursement methodologies including revenue codes and rates, as well as knowledge of federal, state and payer specific regulations and policies is a plus
• Knowledge of one or more specialties; Dental, Family Health, Infection Disease, Pediatrics, Women’s Health – GYN / Obstetrics, Mental Health,
• In depth knowledge of CPT4 and ICD10 Coding required
• Working knowledge of Medical Billing Systems / Electronic Health Records – eClinicalworks experience strongly preferred
• Excellent oral and written communication skills – be able to train and provide information in a clear and concise manner; good interpersonal skills to communicate effectively with providers, patients, clinical and administrative staff.
• Strong computer skills with fluency in Microsoft Office applications including Excel, Outlook, and Word

Benefits

Salary is commensurate with experience. We offer competitive salary and great benefits. Medical plan, dental insurance, short- and long-term disability insurance, Flexible Spending Account, TransitChek, a generous paid time off plan, and a 403 (b) retirement savings plan.

Job Type: Full-time

Experience:

• eClinicalworks: 1 year
• Billing and Coding (Medical and/or Dental) FQHC: 3 years
• solid understanding of Medicaid, Medicare: 1 year
• Medical Billing Systems: 1 year

Education:

• High school or equivalent