Job Specification:
- Manage more complex tasks related to revenue cycle processes, including reviewing claim rejections, resolving billing discrepancies, and following up on denied claims.
- Provide leadership and mentoring to junior process associates, ensuring they understand procedures and provide quality work.
- Assist with the coordination of processes between coding, billing, and collections departments to improve overall workflow efficiency.
Work with payers to investigate and resolve claim denials, ensuring that all necessary documentation and evidence are provided for reconsideration. - Perform quality checks and audits on claims and billing to ensure compliance with healthcare regulations.
- Contribute to process improvement initiatives aimed at reducing claim errors and enhancing the overall revenue cycle.
Requirements and skills:
- Several years of experience in medical billing, coding, or revenue cycle management.
- Strong understanding of healthcare insurance processes, payer contracts, and coding guidelines.
- Excellent communication and interpersonal skills for collaborating with internal teams and external partners.
- Ability to manage and prioritize multiple tasks with tight deadlines.
Analytical skills to identify process inefficiencies and implement improvements. - Strong leadership and mentoring abilities.
- Proficiency with healthcare billing software, spreadsheets, and reporting tools.
