Revenue Cycle Specialist

Position Summary

The Revenue Cycle Specialist is responsible for performing billing functions that enable and expedite collections. The Revenue Cycle Specialist helps improve cash flow and participates in managing the overall health of the company's receivables.

Essential Responsibilities

• Develops, implements, and manages manual billing activities for assigned facilities, including identifying and taking corrective action where needed to improve processes.
• Excellent customer service with the ability to communicate to both insurance companies as well as families in the efforts of collecting outstanding balances.
• Review client bills for accuracy and completeness and obtain any missing information.
• Prepare, review, and transmit claims using billing software, including electronic and paper claim processing.
• Utilizes system reports to reconcile payments posted in practice management systems.
• Works electronic insurance rejections to retransmit with corrected insurance information.
• Monitors census daily to ensure completeness and accuracy.
• Works rebills submitted to the billing department through the electronic billing system or payer source.
• Re-bill and appeal claims based on payer rejections and denials.
• Accurately post payments and adjustments.
• Resolve issues that arise from information/claims submitted as well as Revenue Cycle issues.
• Review credit reports and process applicable refund to client or insurance carrier.
• Understand and interpret insurance Explanation of Benefits, knowing when and how to ensure that payment has been received.
• Research and resolve rejected, incorrectly paid and denied claims.
• Respond in a professional and timely manner to all billing-related inquiries from clients, staff and payers.
• Understands authorizations and limits to coverage such as the number of authorizations/units.
• Maintains a strict level of confidentiality for all company, departmental, and healthcare provider information.
• Policies and Procedures - demonstrates knowledge and understanding of organizational policies, procedures and processes.
• Backup to Benefits verification process. Understands and can accurately complete a Verification of Benefits as requested by admissions team.

Education and Experience

• Associate's Degree or High school diploma with at least 3-5 years’ experience with insurance billing and collections.
• 3-5 years’ experience acting as a liaison between insurance companies and family members/guarantors.
• Prior experience in Mental Health, Substance Abuse Disorder Treatment, or behavioral healthcare field preferred

Skill Competencies

• Strong problem solving and analytical skills.
• Demonstrates a high level of follow through.
• Excellent verbal and written communication.
• Ability to exercise sound judgment and discretion.
• Excellent organizational and time management skills.
• Excellent interpersonal and relationship building skills.
• Ability to prioritize and multi-task.
• Proficiency with Microsoft Office programs.

Physical Requirements

• While performing the duties of this job, the employee will be required to communicate with peers, clients, families, other facilities and/or vendors.
• Performs duties that require the employee to sit or remain stationary for extended periods of time.
• Job performance will require the ability to move throughout the building and may require walking around facility grounds.
• While performing duties employee may be required to sit stationary for long periods of time.
• While performing the duties of this job, the employee may be required to talk or hear, sit, stand, walk, reach, climb or balance, stoop, kneel, crouch or crawl, taste or smell.
• Ability to move up to 25 pounds.

Lifeskills South Florida provides equal employment opportunities without regard to race, color, creed, ancestry, national origin, ethnicity, sex, gender, sexual orientation, marital status, religion, age, disability, gender identity, genetic information, service in the military, or any other characteristic protected under applicable federal, state, or local law. Equal employment opportunity applies to all terms and conditions of employment.[company name] reserves the rights to modify, interpret, or apply this job description in any way the organization desires.  This job description in no way implies that these are the only duties, including essential duties, to be performed by the employee occupying this position.  Reasonable accommodations may be made to reasonably accommodate qualified individuals with disabilities. This job description is not an employment contract, implied or otherwise.  The employment relationship remains “At-Will.”