Job Description
*THIS IS AN ONSITE POSITION*
*NO REMOTE POSITIONS AVAILABLE*
Nextus Billing Solutions specializes in Billing and Claims services for Behavioral Health/Substance Abuse facilities. We are seeking motivated individuals with a desire to be a part of a winning team. We are a fast paced, progressive company with our main headquarters based in Boca Raton, Florida and our 2nd office located in Philadelphia, Pennsylvania.
Job Summary
The Revenue Cycle Specialist performs a variety of functions for the overall patient billing process including securing payment to maximize collections by following up on outstanding insurance claims to facilitate adjudication of high difficulty cases. This role will require an understanding of expert level methods of claims adjudication.
Responsibilities and Duties
- Effective follow up on outstanding charges via payer web portals, phone and other computerized methods
- Work AR strategically, appropriately assessing priority based on report analysis.
- Communicate with Account Management team on high profile issues when assigned special projects.
- Be familiar with excel functions including basic statics and look up formulas, pivot tables and conditional formatting.
- Be familiar with pulling reports from billing software, workflow tools and third-party websites for analysis.
- Facilitate adjudication of claims with expert level barriers to payment occurring.
- Develop and carry out training plans with incoming specialists and associates.
- Assist RCM Team Lead on completion high level projects with department wide impact.
- Maintain open line of communication with leads, seeking advice and escalating issues when there is a lack of familiarity.
- Backfill responsibilities of RCM Specialists when workflow dictates.
- Produce at the level specified by KPI/QA Benchmarks set forth by RCM Manager.
- Working through insurance denials and rejection of claims with insurance companies
- Communicates status of resolution efforts
Qualifications and Skills
- Collections; Posting Charges; Appeals & Denials; Claims; EOBs
- Out-of-Network Commercial Insurances knowledge
- Familiar with Kanban, or similar organizational tools
- Proficiency with Microsoft Office products including Word, Excel, and Power Point
- Effective communication skills, both verbal and written via phone and email
- Experience with Substance Abuse industry, highly preferred but not required
- Familiar with CPT, HCPCS and ICD 10
*5 years Minimum Revenue Cycle Collection Experience required*
Benefits
- Medical, Dental, Vision and Other Supplemental Coverage
- Paid Time Off; Paid Holidays
- 40-hour work week
- Positive work environment
Job Type: Full-time
Pay: $51,000.00 - $65,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- Day shift
- Monday to Friday
Work setting:
Education:
- High school or equivalent (Required)
Experience:
- Collections: 5 years (Required)
- Medical billing: 5 years (Preferred)
Ability to Relocate:
- Philadelphia, PA 19123: Relocate before starting work (Required)
Work Location: In person