Unified Women’s Healthcare
Revenue Cycle Specialist
Unified Women’s Healthcare, Virginia, Minnesota, United States, 55792
Overview
Unified Women’s Healthcare is a company dedicated to caring for Ob‑Gyn providers who care for others, be they physicians or their support staff. A team of like‑minded professionals with significant business and healthcare experience, we operate with a singular mindset - great care needs great care. We take great pride in not just speaking about this but executing on it.
As a company, our mission is to be an indispensable source of business knowledge, innovation and support to the practices in our network. We are advocates for our Ob‑Gyn medical affiliates – enabling them to focus solely on the practice of medicine while we focus on the business of medicine.
We are action oriented. We strategize, implement and execute – on behalf of the practices we serve.
The Revenue Cycle Specialist is responsible for resolving claim issues including denials, payment variances, and any other unresolved issues that may arise directly from internal and external customers. There is an expectation of consistent and clear communication to multiple internal and external entities to collaborate and resolve issues.
Responsibilities
Resolve Accounts Receivable and Collections, including:
Review, Follow Up, and Appeal denied claims according to standards
Determine accuracy of Insurance payments and follow up on discrepancies
Initiate, Follow Up, and Respond on payer reimbursement issues
Communicate with Practices and Payers regarding claim denials and payer trends
Analysis and Quality Review of work completed by third parties
Build and generate reports, as needed
Qualifications
High school diploma or equivalent; post secondary degree preferred
Minimum of 2 years current experience interpreting insurance explanation of benefits, patient benefit plans; policy coverage and patient responsibility
Minimum of 2 years current experience working with medical claims, billing and collections, and appeals; OB/GYN specialty preferred
Experience working with healthcare practice management systems, (Athenanet preferred)
Experience working with cloud‑based Customer Relationship Management (CRM) technology (Salesforce preferred)
Experience with Microsoft Office with proficiency with Microsoft Excel
Excellent verbal and written communication skills with internal and external customers
Ability to collaborate effectively in a cross‑functional team environment
Experience and knowledge of commercial and governmental insurance payer and clearinghouse portals (Availity, Navinet, Optum, etc.) including billing guidelines and policy updates
Working knowledge of Medical Billing & Coding required, Certification preferred
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As a company, our mission is to be an indispensable source of business knowledge, innovation and support to the practices in our network. We are advocates for our Ob‑Gyn medical affiliates – enabling them to focus solely on the practice of medicine while we focus on the business of medicine.
We are action oriented. We strategize, implement and execute – on behalf of the practices we serve.
The Revenue Cycle Specialist is responsible for resolving claim issues including denials, payment variances, and any other unresolved issues that may arise directly from internal and external customers. There is an expectation of consistent and clear communication to multiple internal and external entities to collaborate and resolve issues.
Responsibilities
Resolve Accounts Receivable and Collections, including:
Review, Follow Up, and Appeal denied claims according to standards
Determine accuracy of Insurance payments and follow up on discrepancies
Initiate, Follow Up, and Respond on payer reimbursement issues
Communicate with Practices and Payers regarding claim denials and payer trends
Analysis and Quality Review of work completed by third parties
Build and generate reports, as needed
Qualifications
High school diploma or equivalent; post secondary degree preferred
Minimum of 2 years current experience interpreting insurance explanation of benefits, patient benefit plans; policy coverage and patient responsibility
Minimum of 2 years current experience working with medical claims, billing and collections, and appeals; OB/GYN specialty preferred
Experience working with healthcare practice management systems, (Athenanet preferred)
Experience working with cloud‑based Customer Relationship Management (CRM) technology (Salesforce preferred)
Experience with Microsoft Office with proficiency with Microsoft Excel
Excellent verbal and written communication skills with internal and external customers
Ability to collaborate effectively in a cross‑functional team environment
Experience and knowledge of commercial and governmental insurance payer and clearinghouse portals (Availity, Navinet, Optum, etc.) including billing guidelines and policy updates
Working knowledge of Medical Billing & Coding required, Certification preferred
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