Troy, Michigan
Revenue Cycle Specialist Job Opening in Troy, Michigan - TRIARQ Health is searching for a confident Revenue Cycle Specialist that is adept at insurance denial recovery with a minimum 2-years of experience.
The candidate must have a proven medical productivity track record, the ability to thrive in a fast-paced production environment independently, a quality oriented self-starter, a team player with a positive attitude, and possess the ability to adapt to a variety of technologies.
Key Responsibilities:
Medical receivables denial management
Perform practice reviews and analysis
Effectively communicate patient and clinical issues
Identify issues or trends with accounts and provide suggestions for resolution
Review account information and necessary system applications to determine the appropriate work activity for the accounts assigned
Verify claim adjudication utilizing appropriate applications, as well as editing claims
Work denials and write appeals
Prepares and submits clean claims to various insurance companies, either electronically or by paper
Reviews accounts for possible assignment and make recommendations to the manager
Monitors fee schedules and insurance denials in order to ensure fully allowed reimbursement
Actively participate with other team members to improve overall team environment
Provide a high level of customer service to both practice and patients by identifying and efficiently resolving insurance and other billing-related insurance
Represent multiple practices in a professional and positive manner
Effective communications with staff and management
Qualifications:
HS Diploma / GED
2 year + A/R/Insurance Collections experience
Ability to read/interpret EOBs
Knowledge of CPT and ICD codes
Experience with CMS-1500 and UB-04 claims
Payer website fluency and IVR
Adapt to change, quickly problem solve and escalate issues as appropriate
Maintain accuracy of work and compliance with all rules and regulations
Strong understanding of various insurance carriers
Knowledge of internet/online, medical billing software, and Microsoft Office Suite with an emphasis on Microsoft Excel and Outlook
Job Type: Full-time
Job Location:
Troy, MI
Required education:
High school or equivalent
Required experience:
A/R/Insurance Collections: 2 years
previous insurance and related healthcare: 2 years
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