RCM Billing & Collections Specialist

The primary purpose of this position is to create claims invoices to 3^rd party insurance carriers for commercial products and to monitor aging to ensure proper and timely payment.

• Responsible for correcting claim data in Acuity Logic system prior to billing for specified plans
• Responsible for submitting both paper and electronic claims in Acuity Logic for specified plans to 3^rd party carriers timely
• Responsible for submitting manual vouchers and invoices to plans that don’t accept claim forms in a timely manner
• Maintain and report personal KPI data to Manager on a weekly basis
• Responsible for interpreting and following up on claim denials from 3^rd Party carriers for specified plans
• Responsible for monitoring the aging of specified plans to ensure prompt and accurate payment for specified plans
• Develops expertise in specific plans assigned to the position and acts as a department and company resource for questions relating to billing of these plans
• Assist AR Manager and Commercial Claim Supervisor on special projects as needed.
• Communicates all system, site, and billing company issues to the AR Manager on a timely basis to allow management oversight and proper resource planning
• Be a resource for retail units for questions relating to billing
• Makes recommendations for efficiencies, processes, etc. which will deliver quality, cost savings, and/or profitability improvements within the department and / or across the organization

• High school diploma or GED or equivalent
• 1 year AR experience with 3^rd party billing
• Knowledge of insurance billing processes
• Entry level PC skills in MS Windows, Word and Excel
• Effective verbal and written communication skills to effectively speak with coworkers, and prepare concise and accurate reports
• Demonstrated ability to work successfully in a team environment, functioning for the good of the team over the individual

• This position requires the ability to communicate and exchange information, utilize equipment necessary to perform the job, and move about the office.