Revenue Cycle Claims Specialist

Overview

Women’s Health Connecticut is seeking to hire a Full-time, Revenue Cycle Laboratory Claims Specialist (Insurance Collector).

Position :
Revenue Cycle Laboratory Claims Specialist (Collector)

Location
:
Women’s Health Connecticut

Employment Type
:
Full-time, 40 hours per week

Working arrangement
:
Hybrid, 2-3 days onsite/in-office

Schedule
:
Monday
- Friday, 8:00am- 5:00pm

Reports to
:
Director of Revenue Cycle Management

Resolve all insurance claims processed incorrectly and/or rejected within specific insurance carriers. Identify trends, billing, and collections concerns and or new product requirements.

• Serves as a representative of Women’s Health Connecticut, displaying courtesy, tact, consideration, and discretion in all interactions with other members of the Women’s Health Communities, and the public.
• Review internal reports and system worklists to determine errors causing denial of claims/correct/resubmit claims based upon appropriate carrier guidelines.
• Utilizing follow up reports, and/or system tools, must contact appropriate insurance company in a timely manner to determine reason for non-payment of claims and claim appeals.
• Follow up with payers to facilitate uninterrupted cash flow.
• Respond in a timely manner by either telephone and or written communication to all requests from divisions, insurance companies and other members of the Women’s Health Communities
• Research updates and mailings for insurance company information regarding changes and or new processes for lab coverage/processing.
• Utilizing websites for verification of patient benefit eligibility and claim status.
• Request necessary changes to insurance company guidelines/posting protocols for internal systems (I.E., Athena rules, RCx rules).
• Trend and communicate any insurance issues to management in a timely manner.
• Provide feedback to Manager regarding any account issues.
• Follow internal protocols regarding departmental communications.
• Participate in initiative-taking team efforts to achieve departmental and company goals.
• Adhere to corporate compliance program guidelines and comply with all safety policies, practices, and procedures within the Women’s Health Communities.
• Maintain and respect the confidentiality of PHI (Protected Health Information) in accordance with insurance collection guidelines, corporate policy, and all HIPAA (Health Insurance Portability and Accountability Act) mandates
• Candidate will have access to PHI based on the HIPAA minimum necessary standards.
• Other duties as assigned by management.

• High School Diploma or GED
• Knowledge of CPT and ICD
  10 specific to laboratory billing.
• 5 years prior experience insurance collections in a medical setting, lab billing/AR experience is a plus.
• Ability to set priorities
• Ability to calmly manage stressful situations.
• Excellent verbal and written communication skills
• Demonstrate strong computer skills (Excel/Outlook/One Note/Word, etc.) as evidenced by proficiency and/or training with applicable software
• Ability to work in a fast paced environment
• Ability to remain seated for up to 8 hours.

Qualified candidates are encouraged to apply to learn more about all the position has to offer!

The job responsibilities provided are intended to be a summary of the job duties. In no instance should the duties, responsibilities, and requirements included in a job description constitute as being all-inclusive. The Company and authorized management personnel reserve the right to review, change, add and/or delete duties, responsibilities, and requirements on a job description as necessary.