Position Summary:

The Revenue Cycle Management Specialist, RCM Specialist, is responsible for claims follow-up and denials management for Rennova owned hospital and clinic operations. The specialist will be responsible for inbound and outbound patient communication. This is an on-site position.

Essential Duties & Responsibilities:

• Perform follow-up on claim rejections and denials to ensure appropriate reimbursement.
• Respond to patient inquiries and establish payment plans in accordance with company policy
• Assists colleagues and other members of the team, as appropriate.
• Process assigned AR work lists including but not limited to:

Denial Management- identify reason for denial, confirm the 3rd-party billing company is actively managing denied claims, & follow up

Credit Balance: Research accounts with credit balance (wrong adjustment, overpayment, or incorrect posting) and process refunds as required.

Unbilled Report: Manually process bills that were not automatically dropped to clearing house

Claims Pending Payments: identify claims that have not been paid and correct accordingly.

Secondary claims: Review and confirm secondary insurance are billed accordingly

• Perform other duties as assigned

Required Education:

• High School Diploma or general equivalency diploma (G.E.D) required
• Associates degree in business, healthcare or related degree preferred

Experience

• 3+ years of hospital claims follow up and/or denials management experience
• Experience working for critical access hospital and /or rural health clinic preferred

Knowledge, Skills and Abilities

• In-depth understanding of medical billing requirements
• Experience working with government and commercial payors
• Understanding of payor and provider credentialing
• Excellent analytical and problem-solving skills
• Excellent written and verbal skills
• Ability to interact with individuals at all levels inside and outside the organization
• Ability to plan, organize and integrate priorities and deadlines.
• Ability to work in a fast-paced environment and remain flexible under stressful situations
• Proficient computer skills and knowledge of billing software, EMR (CPSI and Athena, a plus), Microsoft Word, Outlook & Excel

Work Conditions and Physical Requirements

• Full-time
• General office working conditions
• Ability to lift, pull or push up to 30 pounds

Job Types: Full-time, Part-time

Pay: $15.00 - $17.00 per hour

Benefits:

• AD&D insurance
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Paid training
• Vision insurance

Physical setting:

• Office

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• Medical billing: 1 year (Preferred)
• denial: 1 year (Preferred)

Work Location: In person

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