Job Title: Revenue Cycle Specialist (REMOTE)
*training for this position will require in-person attendance for a minimum of three weeks in Fairfax, VA
Type of Position: Full-Time
Fairfax Neonatal Associates is seeking a full time, full remote Revenue Cycle Specialist to join our team. Fairfax Neonatal Associates started one of the first neonatal intensive care units in Northern Virginia with seven beds at the Fairfax Hospital in 1973. Today, the Fairfax Neonatal Associates NICU is one of the largest in the region.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Register patient and guarantor demographic information to Athena EMR as needed
- Verify and obtain insurance packages that are valid to submit for services provided
- Monitors claims throughout the processing life cycle to ensure accurate and timely corrections and/or edits for resubmission. Investigates, and resolves errors. Research and resolution of claims based on assignment, the process of which includes but not limited to:
- Contacting payers via website (primarily) calling when necessary
- Navigating cross-departmentally
-Writing appeals and facilitating their direction to Athena CBO for
- All other activities that lead to the successful adjudication of eligible
- Manage and resolve Fully Worked Receivables, complete special project work, review and respond to adjustments / payment data with approval (or initiate appeal) communicate trends and root issues through proper lines of reporting
- Prepares appeal letters and documentation for denied claims, submits, and monitors to close. Prepares second level appeals documentation when necessary.
- Responds to patient, staff, and insurance company questions related to claims. Educates the family regarding coordination of benefits if necessary.
- Posts credit balance accounts in Athena for refunds on accounts under insurance, including address verification, documentation preparation and account notations.
- Receive calls or emails from Patient Financial Specialists with patient’s requesting advanced assistance with their account. Assist with phone coverage.
QUALIFICATIONS AND EDUCATION REQUIREMENTS
Education and Training
- HS Diploma or equivalent
- Minimum two years professional work experience preferably in medical or insurance coding, billing or collections. Experience working with one or more payor types to include, Medicaid, or third-party commercial insurance companies.
- Bi-lingual in Spanish a plus.
- 2+ years
- Athena Collector experience preferred
KNOWLEDGE, SKILLS, AND ABILITIES
- Strong knowledge of medical terminology, coding (CPT / ICD-10), and billing and collection practices and procedures (charge entry, payment posting, and denial management and appeals.)
- Knowledge of payor contract requirements including authorization and claims filing and submission criteria.
- Understands the full life-cycle billing process from demographics entry to collection, including the collection module.
- Strong communication and interpersonal skills including the ability to establish and maintain effective working relationships with patients, employees, and insurance company representatives.
- Strong client service skills, including the ability to use appropriate judgment, independent thinking, and creativity when resolving client / payor issues.
- Strong organizational skills with strict attention to detail.
- Ability to follow corporate billing processes, procedures and standards, including adherence to HIPAA guidelines and regulations and FNA compliance standards.
- Ability to review and resolve claim issues and reconcile accounts.
- Ability to balance multiple tasks/priorities simultaneously within a deadline, production driven environment with limited supervision.
- Knowledge of Athena Collector co-sourcing model; Microsoft products including Word, Excel, PowerPoint and Outlook.
Requires sitting and standing associated with a typical office environment.
Manual dexterity needed for using a calculator and computer keyboard.
Ability to use telephone equipment.
Fairfax Neonatal Associates (FNA) offers competitive pay, benefits and generous paid time off for full time employees.