Job Description

Job Description

As a Revenue Cycle Specialist, you will provide administrative support in the post-payment review function of the medical revenue cycle process. Review paid claims, identify claims that meet No Surprises Act requirements, retrieve documents for NSA submissions, initiate NSA submissions, work with 3rd party vendors, maintain logs, and meet all Federal and State deadlines. This is a fantastic opportunity to grow your career in medical billing and collections.

Essential Functions:

Review and verify claim meets No Surprises Act requirements

Maintains the database and logs by entering, updating, and retrieving data, as well as formatting and generating reports.

Assists in the resolution of outstanding accounts receivable problems from past due accounts.

Responds to inquiries from customers or external collection resources.

Places calls and sends messages to those with unresolved issues.

Understands and maintains all governmental, regulatory, and company billing and compliance regulations and policies for payers

Follow up with payers, third-party vendors, entities, and other appropriate parties to collect outstanding balances promptly

Identifies and reports to management any payer, or third-party vendor issues concerning billing and collections

Reviews, analyzes, and reconciles post-payment accounts

Adheres to the letter and spirit of the company Code of Conduct, the AdvaMed Code, MedTech Code, and all other company policies.

Ensures Compliance with applicable governmental laws, rules, and regulations, both in the United States and internationally, by completing introductory and annual training and maintaining knowledge of compliance as it applies to your role

Represents the company in a professional manner and uphold the highest standards of ethical business practices and socially responsible conduct in all interactions with other employees, customers, suppliers, and other third parties

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com .

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Skills and Requirements

• 1 - 2 years of related experience (Accounts Receivable experience, medical equipment AR, home health care AR, or collections experience)

• NSA experience - No Surprises Act requirements

• High school diploma or equivalent required

• Ability to complete 28 AR Collections claims per day (minimum)

• Experience working with complex Denials - ex) medical necessity issues, patient does not have coverage, etc Experience reviewing and verify claim meets No Surprises Act requirements

Maintains the database and logs by entering, updating, and retrieving data, as well as formatting and generating reports. null

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion,sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military oruniformed service member status, or any other status or characteristic protected by applicable laws, regulations, andordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to HR@insightglobal.com.

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