Revenue Cycle Specialist—Full Cycle

United States·ParsippanyFull-timemid

Revenue Cycle SpecialistHealthcare Non-Clinical

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Quick Summary

Key Responsibilities

The Revenue Cycle Specialist—Full Cycle is responsible for the execution and management of the revenue cycle process from beginning to end for their assigned offices. As an Insurance Processor,

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Revenue Cycle SpecialistHealthcare Non-Clinical

Join Max Surgical Specialty Management, an innovative leader in the healthcare industry, as we embark on an exhilarating journey of growth and expansion!

We are seeking a motivated and dynamic individual to join our Revenue Cycle Management Team as a Revenue Cycle Specialist—Full Cycle.

What You'll Do:

The Revenue Cycle Specialist—Full Cycle is responsible for the execution and management of the revenue cycle process from beginning to end for their assigned offices. As an Insurance Processor, you will be an integral part of the RCM team as well as each office you support. This role requires attention to detail as well as flexibility.

The successful candidate will be able to:

Review all patient insurance information needed to complete the billing, collections, appeal, and/or cash processes to ensure clean claims submission to insurance carriers
Review all charges, coding and prepare for claims for electronic submission
Work error reports from clearing house
Obtain required attachments for claims submission from various EMR’s
Resolve billing discrepancies and claim denials through follow-up with insurance companies
Review and interpret dental EOBs (Explanation of Benefits), including patient deductibles, co-pays, and insurance/third-party correspondence
Research and navigate insurance policies, benefits, and exclusions to provide accurate information to patients & management team
Monitor outstanding claims and follow up with insurances to ensure timely payments
Follow up to all third-party payers and self-pay accounts documenting appropriate information thoroughly on accounts
Demonstrate a professional image in dealing with the public, patients, clinical offices, and insurance carriers
Review credit-balance accounts on a weekly basis
Submit corrected claims or appeals to insurances carrier for both Medical & Dental
Perform appropriate adjustments, when required
Gather payor trends and provide feedback to management
Identify and resolve specific coding issues, providing feedback to management
Work with internal revenue cycle and administrative teams to identify and manage 3rd party payor denials, overpayment, and underpayment issues
Contact patients regarding coordination of benefits, insurance payments mailed to patient, and outstanding patient balance
Communicate with leadership, patients, and insurance representatives to clarify billing discrepancies
Communicate with healthcare providers, patients, and insurance representatives to clarify billing discrepancies
Perform any and all other duties as assigned

High School Diploma required, Medical Billing and/or Coding Certification highly preferred
3+ years of hands-on experience in healthcare revenue cycle management, with a proven track record of optimizing processes
Proficient in all Microsoft Office applications as well as medical office software
Proven experience in healthcare billing
Sound knowledge of health insurance providers
Strong interpersonal and organizational skills
Excellent customer service skills
The ability to work in a fast-paced environment

What We Offer

~1 min read

✓Highly competitive salaries & annual performance and compensation reviews

✓Competitive health insurance and benefits, including medical, dental, vision, disability, and more

✓401k retirement savings plan that includes employer match

✓Generous Paid Time Off, sick leave, and paid holidays

✓Advance your career growth with opportunities in the most extensive growing oral surgery practice in the Northeast

Established in September 2022 as the Northeast region’s first oral and maxillofacial surgery-only specialty platform, MAX Surgical Specialty Management is a surgeon-led management services organization developed with clinical and surgeon autonomy at its core. Today, MAX supports surgeons across New Jersey, New York, Pennsylvania, Vermont and Connecticut, enabling practices to channel resources, skills and knowledge within the oral surgery specialty, leading industry advancements and delivering the highest standard of patient care. Surgeons have access to a curated network that allows them to collaborate with and work alongside a diverse pool of highly skilled peers who are leaders in their specialty. MAX safeguards surgeons’ independence while offering robust support systems, access to advanced technology and opportunities for financial growth.

Integrity-driven. Patient-focused. Experience the difference at www.max-ssm.com.