We are currently seeking a qualified RCM Intake Specialist to join our constantly growing team. This role will serve as the initial point of contact for other departments and patients to help facilitate their services. The Intake Specialist will be responsible for accurately checking insurance eligibility and coverage to assign patients to other members of the RCM team while ensuring that we have received all relevant demographics from referral sources and assist in assuring agency compliance with state and federal regulations agencies.
Responsibilities include:
- Initiating and tracking the life-cycle for all referrals during the intake process
- Maintaining effective and efficient data entry for internal patient tracking software and excel trackers
- Disseminating relevant information for all appropriate disciplines
- Coordinating with the Operations team to obtain all needed documentation for authorization and billing submissions
- Acting as a liaison and resource for patients, staff and management
- Prompt communication with other departments and staff on referral status from an RCM perspective
- Optimally assigning referrals / patients to authorization representatives for completion while prioritizing the benefit verification and authorization team’s workflow
- Daily reconciliation of outstanding referrals to ensure timely acceptances / denials
- Initiating discharge process for patients by coordinating with the scheduling and clinical department
- Calling on policies for which a portal verification of benefits isn’t adequate for acceptance
- Identifying and preventing potential billing errors, abuse and fraud
- Maintaining appropriate records, files, documentation, etc.
- Assisting in development of new processes within benefits and authorizations, as well as within other departments
Required Qualifications:
- 2-3 years of medical insurance intake experience (eligibility and benefit verification)
- 2-3 years of Customer Service experience
- Excellent organizational and analytical skills
- Extensive experience navigating through insurance portals (Commercial, Worker’s Compensation, Medicare and other Government payors)
- Strong knowledge of medical terminology, deductibles, co-insurance, co-pays, coverage / carve-outs, including CPT, HCPCS, ICD-10, CMS-1500 and UB04 data elements
- Strong attention to detail and ability to interpret clinical documentation
- Understands issue resolution and escalates effectively
- Strong experience with Microsoft Office (particularly Microsoft Excel and Outlook)
- Excellent written and verbal communication skills
- High School Diploma or equivalent (GED) required
- Commitment to maintaining confidentiality while adhering to ethical standards in healthcare
Preferred Qualifications:
- AAPC Certifications
- Ability to sustain efficient work in a fast-paced work environment
- Home Health experience (2+ years)
- Experience with KanTime (EMR)
This position is full-time, Monday-Friday. Employees are required to work our normal business hours of 8:00 AM - 5:00 PM. It may be necessary, given the business need, to work occasional overtime.
Schedule:
- Day shift
- Monday to Friday
- Weekend availability
Supplemental pay types:
Work Location:
Job Type: Full-time
Pay: $47,500.00 - $52,500.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Medical specialties:
Schedule:
Ability to Commute:
- Plano, TX 75074 (Required)
Ability to Relocate:
- Plano, TX 75074: Relocate before starting work (Required)
Work Location: In person