This position is responsible for the resolution of outstanding and/or denied claims based on third party claim processing
rules within established timelines. The Revenue Cycle Associate reports to the central business office supervisor or
manager.
Key Responsibilities:
- Meets goals and objectives in assigned area.
- Complies daily with departmental policies and procedures.
- Performs collection activity to ensure proper resolution and reimbursement on claims.
- Provides thorough, courteous, and professional assistance to coworkers and patients.
- Ensures that all claims are billed and collected and meet all government mandated policies for Integrity and
Compliance.
- Collaborates with hospital departments in the resolution of accounts.
- Resolves claims processing issues with third party payers and provide all required information timely; involves
patients and family members (where necessary) to ensure timely resolution of claims with insurance companies.
- Resubmits clean and accurate claims to insurance companies in a timely and compliant manner.
- Researches, prepares, and submits appeals to insurance companies.
- Details all actions taken on account with clear and concise notes.
- Monitors and recognizes denials and/or issues that may be trends and escalate to supervisor as needed; and
- Maintain strict confidentiality and adhere to all HIPAA guidelines/regulations
- Demonstrate excellent communication skills, both written and verbal.
Read Full Description