Job type full-time
Not provided by employer
Full job description
Description:
Exciting opportunity with adapthealth for an insurance collections specialist!
At adapthealth we offer full-service home medical equipment products and services to empower patients to live their best lives – out of the hospital and in their homesWe are actively recruiting in your areaIf you are passionate about making a profound impact on the quality of patients’ lives, please click to apply, we would love to hear from you.
Lead, revenue cycle management (rcm)
We are looking to hire a highly effective rcm lead who will be the subject matter expert for accounts receivables for aetna, carecentrix, cigna, humana, tricare and unitedhealthcareThis position will lead rcm domestic and global teams by providing work assignments, feedback, training and guidance to ensure rcm staff is following department protocol and processesThis individual will need to possess strong microsoft excel and root cause skills to be able to identify payor trends and develop rcm process improvementsWorks directly with supervisor and manager to ensure all reimbursement issues are resolved and that unprocessed claims, denials and appeals are processed timely and accurately.
Essential functions and job responsibilities:
Mentors guide and provide oversight assistance to the teamThe majority of adapthealth rcm team members are located offshore.
Applying subject expertise in evaluating business operations and processes.
Identify trends and root causes related to inaccurate insurance billing, and report to the manager while resolving account errors.
Consulting across teams, providing mentorship, and contributing specialized knowledge.
Demonstrated various techniques and documentation to streamline the production process.
Respond to internal inquiries for coaching assistance via the subject matter expert queue, office communicator, and email
Assume responsibility for resolving team member escalations by working with multiple business partners while consistent communication is present with the member
Coach others on how to navigate through systems to find information needed for calls
Take escalated phone calls that cannot be effectively resolved by team members.
Communicate with other departments, front end staff regarding billing issues and trends to work toward an account resolution and decrease insurance denial percentages within adapthealth.
Handle all insurance payer disputes that are filtered into the department.
Develops and enhances the process and payer-specific work job aids and standard operating procedures.
Investigate escalated insurance billing inquiries and inaccuracies and take appropriate action to resolve the account.
Competency, skills, and abilities:
Decision making
Strong analytical and problem-solving skills with attention to detail
Excellent verbal and written communication
Excellent customer service skills
Proficient computer skills and knowledge of microsoft office
Requirements:
Education and experience requirements:
High school diploma required; associated degree preferred
Three (3) years related work experience in health care administrative, financial, insurance, customer services, claims, billing, call center, or management regardless of industry required
Two (2) exact job experience in hme, diabetic, home medical supplies, pharmacy, hh environment is preferred.
Physical demands and work environment:
The work environment may be stressful at times, as overall office activities and work levels fluctuate
Must be able to bend, stoop, stretch, stand, and sit for extended periods of time
Subject to long periods of sitting and exposure to a computer screen
Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use
Mental ability to convey knowledge and mentor others
Mental ability to analyze information, problem solve and identify areas of opportunity
Must be able to lift 30 pounds as needed
Excellent ability to communicate both verbally and in writing
May be exposed to angry or irate customers or patients
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Job activity
Posted 30+ days ago
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