Revenue Cycle Management Specialist

Advanced Data Systems (ADS) stands out as perhaps the example of reliability and stability in an industry well-known for vendor name changes, mergers and acquisitions, and general uncertainty.

The Revenue Cycle Management Specialist will be responsible for all aspects of the claim cycle. Will verify compliance and quality of all claims before submission, perform follow up on all rejected and denied claims ensuring timely correction and resubmission. Ensure timely and proper payment from all payers. Follow up on any outstanding claims. Identify and quickly rectify any issue that interrupts the Revenue Cycle.

• Perform follow up on outstanding physician claims.
• Identify issues resulting in non-payment of claims due to internal/external issues and rectify such issues in a timely manner.
• Maintains strict patient confidentiality/HIPAA compliant.
• Provide excellent customer service to patients and clients as needed.
• Maintain knowledge of ICD9/ICD10 diagnostic as well as CPT/HCPCS procedural coding.
• Maintain thorough knowledge of insurance carriers and their claim guidelines/requirements.

• Must have at least 5 years experience with Revenue Cycle Management/Medical Billing.
• Practice Management Systems. Medics II, Medics Premier and/or Medics Elite experience a plus.
• Electronic claim submission via Clearinghouse. Emdeon experience a plus.
• Billing for multiple specialties.
• Billing for both Professional and Institutional claims with a solid understanding of HCFA-1500 and UB-04 claim forms as well as the electronic equivalent.
• ERA processing.
• EDI Enrollment.
• Excellent oral and written communication skills.
• Experience with provider credentialing a plus.