RCM Specialist I Insurance Verification Rep

Description

Who we are:

Aligned Orthopedic Partners is a well-respected private orthopedic team comprised of highly trained, board-certified orthopedic surgeons devoted to delivering the highest orthopedic care possible. Our commitment to finding the best solutions for individual needs sets us apart from the competition. We take pride in providing exceptional care while remaining friendly, courteous, and efficient. Aligned Orthopedic Partners is recruiting for an experienced RCM Specialist I to support billing operations across multiple locations.

PRIMARY RESPONSIBILITIES MAY INCLUDE:

• Insurance Verification/Prior Authorization
• Accurately perform insurance verifications, pre-certification/pre-authorization functions as required/assigned in a timely manner.
• Ensure new patients added to the schedule are properly verified and authorized to be seen; updates patient accounts.  
• Perform electronic insurance eligibility confirmation when applicable and document results.
• Assign insurance plans accurately.
• Contact patients and insurance plans to confirm or obtain missing information.
• Respond to patient and staff inquiries related to insurance questions. 
• Communicate insurance changes or trends to staff and the RCM team.  

• Patient Accounts
• Provide telephone support and coverage, as needed.
• Respond to patient inquiries in a timely fashion.
• Communicate with patients or visitors, including collecting payments and co-payments.
• Provide patient financial counseling and education about payment options, ensuring appropriate authorization from Manager and/or treating physician, as indicated and per practice policy.
• Negotiate patient payment arrangements per guidelines.
• Aggressively work patient accounts receivable; report activities and trends to RCM Team Lead or Manager on a weekly basis. 
• Accurately and efficiently enter patient information into practice management software, including payment information, and updating patient accounts and balances. 
• Communicate any insurance issues to designated RCM Specialist II.
• Reconcile daily collections, per established money handling procedures; prepare bank deposit daily and forwards to Manager.

• Billing Support
• Prepare billing correspondence; maintain all billing related documents per protocol – seek assistance from RCM Team Lead or Manager as needed.
• Perform clerical functions, including ordering supplies, generating letters, processing mail, scanning documents and producing end-of-day reports. 
• Perform registration function for designated hospital visits; ensure completeness of information provided from physicians

• General
• Check designated voicemail throughout the day to ensure prompt follow up.
• Perform designated functions required for accurate daily close of the billing system.
• Work collaboratively with peers to cover workloads, special projects, and other duties. 
• Work with all other functional areas of the Revenue Cycle Management team, including EDI/claims, charge posting, payment posting and patient accounts.
• Communicate all issues or potential issues to leadership.
• Assist in preparation of practice summary reports, as requested or assigned.
• Attend regularly scheduled business office meetings; assist in identifying “best coding and billing practices” to ensure appropriate reimbursement.

POSITION REQUIREMENTS:

• High School Diploma 
• Able to multi-task and capable of remaining calm in a stressful situation
• Able to use a multi-line telephone system and the billing computer program
• Familiarity with federal, state and commercial insurance guidelines and policies preferred
• Excellent written, verbal, and interpersonal communication skills.
• Proficiency with Microsoft Excel and Word
• Accurate and efficient data entry skills
• Strong attention to detail
• Proficient computer software and database skills.
• Strong analytical skills.
• Demonstrates working knowledge of medical terminology, diagnostic and procedural coding and the medical billing process
• an RCM Specialist I cross-trained and routinely performing two of the three primary responsibility functions listed above (other than General) may be considered for an RCM Specialist II position

What we offer:

We strive to enrich the lives of our team and offer a variety of health and wellness benefits including medical and dental benefits, employer-paid short-term and long-term disability coverage, a matching 401K program, generous paid time off, and an environment that celebrates continuous learning and development. 

Equal Opportunity Employer

Aligned Orthopedic Partners is an equal-opportunity employer. We promote diversity of thought, culture, and background. We celebrate what makes us different and are committed to building a team that represents a variety of experiences. All employment is decided on the basis of qualifications, merit, and business need.