A network of intensive outpatient (IOP) addiction treatment centers in Maryland, Pennsylvania, northern Virginia, and Washington, DC, is seeking to hire a Full-time Revenue Cycle Analyst to join its Burtonsville location in a hybrid capacity. The Revenue Cycle Analyst responsibilities will include ensuring that clearinghouse edits, denials, and payment posting are processed and completed in a timely manner. The ideal candidate is a flexible self-starter who is able to multi-task, while remaining focused and organized.
- Post payments and rejections to ensure accurate posting
- All 835 files must be posted daily along with checks that are received(manual and electronic)
- Participate in month end processes to reconcile payments on a daily, weekly and monthly bases
- Research all offsets, unapplied cash and all zero dollar remits must be posted
- Resolve and process overpayments, credit balances received from insurance co.
- Review insurance remittance advice for accuracy
- Coordinate with insurance carriers to reconcile/resolve any issues
- Must possess in depth knowledge of eob’s ,copays, reason and remark codes, adjustments, write offs, EFT’s, ERA’s and healthcare terminology
- Complete all clearinghouse edits within 48 hours of receipt of the edit.
- Interprets and evaluates appeals to include follow-up with payers to assure timely turn around for claims resolution and reimbursement.
- Assist with identifying and escalating payer issues in a timely manner.
- Processes and completes the daily workload of claims assigned, reporting backlogs as identified.
- Identifies registration errors and reports all trends to management. All work must meet QA and productivity standards to ensure departmental benchmarks are met.
- Must be able to interpret explanation of benefits and have a clear understanding of payer methodology.
- Ensure strict compliance with Medicaid, Medicare and all other Federal, State and Local regulatory procedures, certifications and requirements, utilizing efficient and effective procedures and process controls.
- Collaborates with Management and participates in process and quality improvement initiatives within the department
- Other duties, as assigned.
- Minimum 5 years’ experience working in a payment posting and accounts receivable environment for a private, nonprofit or public healthcare organization.
- Proficient in all Microsoft Office applications as well as medical office software.
- Proven experience in healthcare billing.
- Sound knowledge of health insurance providers, especially Medicaid and Medicare.
- Strong interpersonal and organizational skills.
- Excellent customer service skills.
- The ability to work in a fast-paced environment.
- Strong attention to detail and accuracy in all work products, including solid documentation skills that ensure proper audit trails.
- Strong oral and writing skills, including internal and external professional letters, transmittals and other sensitive communications; and constructing and presenting professional highly sophisticated internal and external reports.
- Flexible self-starter who is able to multi-task, while remaining focused and organized.
- Strong analytical skills, with experience integrating strategic vision into an operational model.
Benefits: Benefit package included.
Schedule: Full-time; Hybrid position; 2-3 days work from home.
Zip code: 20866