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Revenue Cycle Rep II

Company: Compassus
Location: Richardson
Posted on: November 13, 2021

Job Description:

Current Compassus Colleagues: Please apply via Workday.Summary:Responsible for reviewing Accounts Receivable and working with assigned payors to obtain reimbursement in a timely and efficient manner. Minimum 2-3 years of health care collections experience required, home health or hospice preferred. Strong knowledge working with Commercial payors and Third Party Insurance Accounts (i.e. Medicaid, Managed Care, HMO, PPO, Auto and Work Comp). Skilled in adhering to rules and guidelines governing collection activities. Comfortable leading and providing oversight to a group of people in daily tasks and guidance. - Essential Duties and Responsibilities:

  • Ensures AR team follows established processes and procedures and answers questions as needed
  • Research and interpret contract terms to identify system issues or inconsistencies in reimbursement that are hindering cash flow
  • Daily communication with payers, government agencies and patients/ guarantors to obtain payment resolution and provide account status information.
  • Work all assigned accounts with established procedures until account is paid, escalated, disputed, or finalized.
  • Seeks account reconciliation on denied claims and exhausts all appeal and reconsideration options within the contracted terms of the payor
  • Ensures proper account documentation which is clear, concise and includes all pertinent information. -
  • Makes appropriate and necessary corrections to patient account information as needed to ensure all compliance regulations are met
  • Immediate and appropriate escalation of payor trends and issues to management which impact cash, aging and processes.
  • Communicates payor trends and acquired knowledge to AR team to optimize account resolution on a daily basis
  • Maintains or exceeds established productivity goals and quality standards.
  • Utilizes electronic software in daily activities
  • Ensures professional verbal and written communication with facilities, clients and co-worker following established guidelines.
  • Adheres to HIPAA and Compliance Policy Guidelines at all times to ensure patient and client confidentiality.
  • Follows time-keeping and attendance policy daily. Supervisory Responsibilities:None. Supervision Received/Required:Follows guidance of direct manager/supervisor as well as company policy. Seeks out assistance when needed from direct manager/supervisor. Other Duties and Responsibilities:Performs other duties as assigned. Provides leadership to others through example and sharing of knowledge and skill. Complies with all company policies and procedures, including the corporate compliance program. Educational and Experience Requirements:High school diploma or GED required. - Require 2-3 plus years of health care medical collections experience, home health or hospice preferred. Knowledge of Commercial, Third Party Insurance Accounts including but not limited to Medicaid, Managed Care, HMO, PPO, Auto and Work Comp. Rules and Guidelines governing collection activities. Language Skills Required:Ability to communicate clearly in both written and verbal format. Mathematical Skills Required:Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages. Proficiency in the use of a 10-key. Reasoning Ability Required:Ability to define problems, collect data, establish facts and draw valid conclusions thru the use of critical thinking skills Certificates, Licenses and Registrations:None required; Medical Billing and Coding Certificate a Plus. Computer Operations:Previous experience should include basic computer knowledge. - Knowledge of Microsoft Word and Excel required. Working accounts in a computerized automated environment. - Physical Demands:Must be able to perform the following, with or without reasonable accommodation: sit for extended periods of time; stand, walk or otherwise move occasionally; use hands to operate a telephone, calculator, computer keyboard and mouse; speak and hear in order to answer questions and resolve problems etc.; move or exert force up to 25 pounds occasionally (files, boxes of supplies, binders, etc.); have visual capability sufficient to read a computer monitor and written documents. Travel Requirements:None Other Skills and Abilities:Uses independent and critical thinking skills to achieve assigned objectives. - Ability to organize and prioritize. - Attention to detail. - Ability to be accurate and timely. - Good decision making skills. - Ability to maintain confidential information.

Keywords: Compassus, Richardson , Revenue Cycle Rep II, Other , Richardson, Texas

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