Revenue Cycle Specialist- Canonsburg, Pa

Preferred Primary Care Physicians (PPCP) is currently recruiting for a full-time Revenue Cycle Specialist to work out of the Central Administrative office located in Canonsburg, PA. The successful candidate MUST have at least 3-5 years of charge entry/ claims/billing/collection experience. Must be able to communicate with patients, payers, outside agencies, and the general public through telephone, electronic, and written correspondence. This position is an on-site position with a Monday-Friday day schedule.
Come join the PPCP team to get a highly competitive starting hourly wage, a fantastic benefit package that includes one of the top 401k plans in the field, and a company that promotes a positive, upbeat environment and healthy work/life balance!
General Purpose of the Revenue Cycle Specialist:
The Revenue Cycle Specialist is responsible for all fiscal functions necessary to ensure the Revenue Cycle process for PPCP is submitted to insurance timely, posting of payments accurately, and manage the denials and Accounts Receivable. The Revenue Cycle Specialist is well versed and crossed trained in all areas of the Revenue Cycle and accustomed to working in a high-volume environment.
Revenue Cycle Specialist Essential Functions:
Revenue Cycle Specialists are responsible to: ensure professional charges and claims are submitted accurately and timely; communicating with insurance companies, communicating with office locations for appropriate medical record documentation, recommending adjustments according to PPCP policies, reviewing the posting and balancing of payment/denial and adjustment transactions necessary for closing accounts, identify and assign appropriate status codes, and review high dollar accounts on a regular basis. The Revenue Cycle Specialist is expected to identify recurring problems and procedural deficiencies that need to be reported to management.

• Understand Primary Care and Internal Medicine CPT coding.
• Ability to multi-task

• Identify root cause issues and demonstrate the ability to recommend corrective action steps to eliminate future occurrences.
• Assist in claim appeal process and/or perform follow-up in accordance with Revenue Cycle policies and procedures.
• Understand third party billing and collection guidelines.
• Read and distribute payer newsletters and relevant communication.
• Appropriately post payments.
• Interpret Explanation of Benefits and follow up on any denials.
• Demonstrate knowledge of the current functionality of the patient accounting systems.
• Identify issues and submit corrective action recommendations.
• Ability to work independently with minimal supervision.

• Meet quality assurance benchmark standards and maintain productivity levels as defined by management.
• Other duties and responsibilities as assigned by leadership.

Qualifications/Prerequisites:

• Must have three to five years of charge entry/claims/billing/collections experience.
• Excellent interpersonal, organizational, communication and effective problem-solving skills are necessary.
• Must be able to communicate with patients, payers, outside agencies, and general public through telephone, electronic and written correspondence.
• Prior working experience on personal computers, electronic calculators and office equipment is needed.
• Must be multi-disciplined in billing, including charge entry, payment posting, collections, denials, credit balances and/or the various payers.
• Prior collections or medical billing experience with basic understanding of ICD10, CPT4, HCPCS, and medical terminology is preferred.
• Familiarity with third party payer guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial.
• This position requires organization and time management skills.
• The incumbent must develop and manage relationships with colleagues in a professional, independent manner.
• The position requires the ability to maintain confidentiality regarding all assignments.

About Us:
At Preferred Primary Care Physicians, preferred health care is simply our standard. Our practice was established in 1995 when a group of dedicated physicians in the South Hills came together for one common purpose: to provide the highest quality care to their patients. Their ingenuity and expertise laid the foundation for our independently owned practice, which now operates out of more than 20 locations in the greater Pittsburgh area. Our elevated level of service is supported by our team-based approach, comprehensive clinical programs, and state-of-the-art outpatient centers. From providing general primary care to managing chronic conditions, we give all of our patients the preferential treatment they deserve.
Come join the team and enjoy a very competitive employee benefit package including medical, dental, vision, company paid life insurance, and 401k with competitive match.
Please visit our website for more info about our company.
EOE