Revenue Cycle Associate - On Site

at  Steward Health Care

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.

• 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 HlPAA guidelines/regulations.
• Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices a plus;
• Understands payer guidelines related to effective claim resolution;
• Knowledgeable and proficient with payer websites and other useful resources;
• Knowledge of revenue cycle and/or business office procedures;
• Highly detail oriented and organized;
• Ability to read, understand, and follow oral and written instructions; and
• Ability to establish and maintain effective working relationships and communicate clearly with customers and insurance companies both within and outside of Steward.

• 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 HlPAA guidelines/regulations.
• Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices a plus;
• Understands payer guidelines related to effective claim resolution;
• Knowledgeable and proficient with payer websites and other useful resources;
• Knowledge of revenue cycle and/or business office procedures;
• Highly detail oriented and organized;
• Ability to read, understand, and follow oral and written instructions; and
• Ability to establish and maintain effective working relationships and communicate clearly with customers and insurance companies both within and outside of Steward