POSITION SUMMARY:

To be fully engaged in providing Quality/No Harm, Customer Experience, and Stewardship by: ensuring the financial integrity of Health First, Inc/HF Medical Management by preforming established financial processes that enable and expedite the billing and collections. This includes: Customer Service, billing claims according to Federal/State and Managed Care rules, regulations, and compliance guidelines, patient account research and resolution, resolution of credits and issuance of refunds, identification of payment variances invoices, follow up and resolution of denied claims.

PRIMARY ACCOUNTABILITIES:

Quality/No Harm:

• Knowledge of business office applications to include Microsoft Word and Excel as well as other standard office equipment
• Demonstrates knowledge of and supports the organizations mission, vision, and value statement.
• Completes work within authorized time to ensure compliance with department standards
• Maintains established benchmarks as related to assigned tasks and shows continual growth and improvement in benchmarks
• Apply Federal/State/Industry standard guidelines in order to resolve claim issues as approved by departments
• Secure needed medical documentation required/requested by payers
• Maintain clean and organized work environment
• Able to respond positively to stressful situations
• Ability to work independently throughout the systems to access and update information as needed
• Constructively participates in achieving departmental goals
• Constructively participates in the team Gallup Action Plan
• Customer Experience: Demonstrates effective communication and problem-solving skills
• Positively and professionally interact with customers and associates
• Demonstrates the ability to work effectively as a team member
• Maintains confidentiality regarding all aspects of operations

Stewardship:

• Processes assigned accounts timely and maintains quality standards as set by the department
• Makes necessary calls to responsible parties/insurance companies for account resolution and properly documents actions within account receivable system
• Reviews and processes accounts from various department assigned reports
• Recognizes trends and escalates issues to management
• Performs other duties as assigned by management

QUALIFICATIONS REQUIRED:

• High School Diploma required
• One year experience in Healthcare Billing and/or AR follow up or related field required
• Excellent verbal and written communication skills
• General knowledge of coding (ICD-9, ICD-10, CPT and HCPCS)
• General knowledge of medical terminology
• General knowledge of account principles
• Computer experience required. Microsoft Windows applications

Job: *Medical Billing

Organization: *Health First Shared Svcs Inc

Title: HFMG Revenue Cycle Specialist I

Location: Florida - Brevard County-Rockledge

Requisition ID: 071908