Senior RCM Specialist

Description

Revenue Cycle Management Specialist are responsible for maintaining a timely revenue cycle for all the goods and

services provided by AdaptHealth. Also responsible for maintaining patient confidentiality and function within the

guidelines of HIPAA. Completes assigned compliance training and other educational programs as required. Maintains

compliant with AdaptHealth’s Compliance Program. 

Patient Financial Services

• Identify trends and root causes related to inaccurate private pay billing, and report to manager while resolving account errors. 
• Investigate escalated customer billing inquiries and take appropriate action to resolve the account.
• Resolve private pay charges for returned payments due returned payments. 
• Resolve accounts pertaining to patient account inaccuracies or patient demographics.
• Respond to Collection agency regarding patient disputes of balances owed on accounts.
• Enroll patients calling regarding financial responsibility and enroll in autopay.

All Rcm Specialist Responsibilities:

• Educate patients, staff and providers regarding authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance changes or trends. 
• Maintains an extensive knowledge of different types of payer coverage, insurance policies, payer guidelines and payer contracts ensure accurate billing and timely payment is received. 
• Responsible for entering data in an accurate manner, into database including although not limited to payer, authorization requirements, coverage limitations and status of any requalification.
• Collaborates with physician offices, AdaptHealth sales and support staff to ensure timely receipt of documentationas well as educating, as necessary. 
• Identify trends and providing feedback and education to internal and external customers on compliant documentation requirements for services provided. 
• Develop and maintain working knowledge of current HME products and services offered by the company.
• Maintain patient confidentiality and function within the guidelines of HIPAA.
• Completes assigned compliance training and other educational programs as required.
• Maintains compliant with AdaptHealth’s Compliance Program
• Performs other related duties as assigned.

Requirements

Competency, Skills And Abilities:

• Decision Making 
• Analytical and problem-solving skills with attention to detail 
• Strong verbal and written communication 
• Excellent customer service skills 
• Proficient computer skills and knowledge of Microsoft Office 
• Ability to prioritize and manage multiple tasks. 
• Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction. 

Education And Experience Requirements:

• High School Diploma or equivalent
• One (1) year work related experience in health care administrative, financial, or insurance customer services, 
• claims, billing, call center or management regardless of industry. 
• Senior level requires two (2) years of work-related experience and one (1) year of exact job experience.
• Exact job experience is considered any of the above tasks in a Medicare certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance.