Revenue Cycle Specialist
Finance & HR
Would you like to be part of a revolution in health care? Then check out this career opportunity at Spreemo, a fast growing digital health company reshaping the way we evaluate and select our doctors. With Spreemo, patients can finally get the answers to whether a doctor has the experience and skill to properly diagnose and treat them. Today, we’re doing this in radiology; tomorrow, we’re taking on the greater healthcare ecosystem.
Spreemo is a cloud-based healthcare marketplace injects transparency of both price and quality of medical services. Our technology uses predictive analytics that enables consumers to make value-based decisions about their doctor. It is a new approach to choosing your doctor and we are working hard to show the world. As we work hard to consumerize the healthcare industry, we take a customer-centric approach to everything we do from sales to support to engineering. We are looking for candidates who are positive, full of energy and eager to change an industry.
Spreemo is seeking several passionate people to join our billing team who share our vision of a smarter, technology-driven healthcare system. As a Billing Associate, you will play an integral role in moving the vision forward.
The Revenue Cycle Specialist will help Spreemo, Inc. deliver excellent customer service both internally and externally. The goal for this position is to provide accurate and timely completion of Revenue Cycle related tasks that will result in proper funding on both the client and provider sides of our business.
Duties and responsibilities
- Collect information required to create invoices
- Process incoming Provider invoices as instructed
- Process outgoing invoices as instructed
- Calculate Provider payments and Carrier charges using established Fee/Charge Schedules accurately and timely
- Generate Carrier invoices accurately and timely
- Validate accuracy of Provider and Carrier invoices per policy
- Manage resolution of exceptions/issues
- Answer Provider inquiries related to payment status accurately and timely
- Scan documents and manage electronic filing systems per policy
- Review invoices and provider bills for accuracy and completeness and obtain any missing information
- Manage Accounts Receivable accounts accurately and timely
- Provide support from Billing through Payment Posting and reconciliation processes
- Accountable for daily productivity goals
- Resolve payment rejections/denials per policy including validate denial reason; coordinate with internal and external resources to overturn the rejection; generate and submit appeals based on rejection reason and contract terms; follow specific Carrier guidelines; escalate where indicated;
- Work projects as identified
- Perform research and make determinations for corrective actions
- Post payments to individual patient accounts accurately and timely
- Reconcile payment posting to lock box and interface with Finance
- Be a Subject Matter Expert and provide related support to less experienced team members
- Maintain work operations by following policies and procedures and reporting compliance issues
- Improve customer experience, create engaged customers and facilitate organic growth
- Answer inquiries by clarifying desired information; researching, locating and providing information
- Resolve problems by clarifying issues; researching and exploring answers and alternative solutions; implementing solutions; and escalating unresolved problems.
- Fulfill requests by clarifying desired information; completing tasks; and forwarding related requests.
- Maintain data integrity by entering customer financial related information accurately and timely.
- Update job knowledge by participating in educational opportunities.
- Communicate with customers/clients via phone, email and letter
- Adhere to Priority Matrix and report same to Team Leader
- Maintain accurate records and document actions and discussions
- Perform Data Entry tasks related to Provider Bills and Carrier Bills
- Perform invoice and payment reconciliation tasks to analyze invoice status
- Proficiency in English
- Strong mathematical aptitude
- Intermediate knowledge of HCFA 1500 and UB04 billing forms preferred
- Intermediate understanding of Explanation of Benefits and Contracts preferred
- Intermediate understanding of ICD-9/10, HCPCS/CPT coding and medical terminology
- Intermediate MSWord, MSExcel
- Advanced business letter writing skills to include correct use of grammar and punctuation
- Knowledge of Workers Compensation healthcare billing protocols preferred
- Three to Five years of experience in a healthcare financial, or equivalent position preferred
- Ability to manage day to day tactical requirements as directed by management
- Customer service orientation
- BS Degree in Business Administration or related field preferred
If you're interested in joining a fun-loving team full of people trying to fix America's healthcare system, send us your resume and cover letter and let us know why you'd like to join our team.
Requisition Number: SPIND2