Variety Care
Billing, Claims Resolution Specialist (66921)
Variety Care, Oklahoma City, Oklahoma, United States, 73116
Overview
Billing, Claims Resolution Specialist (66921) – Variety Care. Department: Billing. Position: Claims Resolution Specialist. Employee Category: Non-Exempt. Reporting Relationship: Manager of Revenue Cycle Management. Responsibilities
Collaborate with the Senior Claims Resolution Specialist and the Manager of Revenue Cycle Management to determine focus areas for collections after reviewing the weekly AR report. Contact third-party payers about outstanding balances and provide requested documentation to achieve resolution. Contact patients with outstanding balances to obtain payment or set up payment plans; send statements and collection letters on past due balances. Track and follow up on payment plans to ensure compliance; perform write-offs, adjustments, and refunds as directed. Work closely with the Billing team to respond to billing inquiries and resolve outstanding balances; answer patient calls and billing questions. Process medical records requests for payers from attorneys; assist front desk staff with patient inquiries and obtaining correct patient addresses. Meet established daily, weekly, monthly, and annual deadlines; manage relationships with payors to improve patient revenue. Uphold Medicare, Medicaid, and HIPAA compliance guidelines related to billing, collections, and PHI information. Follow written and verbal instructions from the Manager of Revenue Cycle Management and Sr. Claims Resolution Specialist; maintain professionalism in communication with patients, clients, insurance companies, and co-workers. Participate in special projects as assigned and support accreditation as a Patient-Centered Medical Home; contribute to the goals of healthcare reform’s Triple Aim by improving care experience, health outcomes, and cost reduction. Perform other duties as assigned. Essential Functions
Must be able to lift and/or move up to 25 pounds. Regularly required to sit, stand, walk, and talk; may need to bend and reach to perform duties. Qualifications
High School Diploma or GED. Two years of prior billing and collections experience. Working knowledge of CPT codes; ability to read and understand Explanation of Benefits (EOB). Strong analytical, independent-thinking, problem-solving, and decision-making skills. Effective communication with individuals at various levels, often in sensitive situations. Proficiency with Microsoft Office and practice management software; bilingual (English/Spanish) is a plus. Preferred Qualifications
Associate degree or equivalent combination of experience and education. Prior medical billing and insurance collections or healthcare revenue cycle experience including payers, managed care contracts, and payer methodology.
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Billing, Claims Resolution Specialist (66921) – Variety Care. Department: Billing. Position: Claims Resolution Specialist. Employee Category: Non-Exempt. Reporting Relationship: Manager of Revenue Cycle Management. Responsibilities
Collaborate with the Senior Claims Resolution Specialist and the Manager of Revenue Cycle Management to determine focus areas for collections after reviewing the weekly AR report. Contact third-party payers about outstanding balances and provide requested documentation to achieve resolution. Contact patients with outstanding balances to obtain payment or set up payment plans; send statements and collection letters on past due balances. Track and follow up on payment plans to ensure compliance; perform write-offs, adjustments, and refunds as directed. Work closely with the Billing team to respond to billing inquiries and resolve outstanding balances; answer patient calls and billing questions. Process medical records requests for payers from attorneys; assist front desk staff with patient inquiries and obtaining correct patient addresses. Meet established daily, weekly, monthly, and annual deadlines; manage relationships with payors to improve patient revenue. Uphold Medicare, Medicaid, and HIPAA compliance guidelines related to billing, collections, and PHI information. Follow written and verbal instructions from the Manager of Revenue Cycle Management and Sr. Claims Resolution Specialist; maintain professionalism in communication with patients, clients, insurance companies, and co-workers. Participate in special projects as assigned and support accreditation as a Patient-Centered Medical Home; contribute to the goals of healthcare reform’s Triple Aim by improving care experience, health outcomes, and cost reduction. Perform other duties as assigned. Essential Functions
Must be able to lift and/or move up to 25 pounds. Regularly required to sit, stand, walk, and talk; may need to bend and reach to perform duties. Qualifications
High School Diploma or GED. Two years of prior billing and collections experience. Working knowledge of CPT codes; ability to read and understand Explanation of Benefits (EOB). Strong analytical, independent-thinking, problem-solving, and decision-making skills. Effective communication with individuals at various levels, often in sensitive situations. Proficiency with Microsoft Office and practice management software; bilingual (English/Spanish) is a plus. Preferred Qualifications
Associate degree or equivalent combination of experience and education. Prior medical billing and insurance collections or healthcare revenue cycle experience including payers, managed care contracts, and payer methodology.
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