JOB DESCRIPTION:
AdvancedMD is hiring a revenue cycle specialist to work directly with clients to identify, prioritize and manage strategic needs for an efficient service workflow and optimal A/R outcomes. The revenue cycle specialist will manage a broad array of functions within the revenue cycle, including: claims resolution, payer tracking and trending, website access, claims status inquiries, client training and contact with the clearinghouse and carriers.
At AdvancedMD we are driven by your success. We engage your unique talents and perspectives. We welcome your ideas on how to do things differently and better. In your efforts to achieve, learn and grow, we support you all the way. If success motivates you, you belong at AdvancedMD.
Medical practitioners across the country turn to AdvancedMD for fully integrated Electronic Health Record (EHR) and Practice Management solutions they can trust. We are one of the nation's largest providers of cloud medical practice optimization software and a leader in cloud electronic health record (EHR), practice management, medical scheduling software, and billing applications for medical practices and medical billing services.
RESPONSIBILITIES:
- Identify and analyze payer reimbursement and denial trends
- Provide client proactive feedback and training on trends and following best practices
- Act as the subject matter expert for the AdvancedMD system
- Proactively build client specific claim edits to avoid future claim denials
- Verify system setup and accuracy
- Communicate and manage internal and external requirements and expectation
- Manage multiple client accounts and requirements at one time
- Work closely with operations and revenue cycle service leadership
- Correct Claims pre-submission for identified edits that will or could prevent a claim denial or delay
- Accountable for keeping up with AdvancedMD system/product changes
QUALIFICATIONS:
- 5+ years of medical billing experience with a minimum of 3 years in at least one of the following specialties required: Dermatology, Pediatric, Otolaryngology, Pulmonary, Cardiology, OBGYN, Gastroenterology, Rheumatology and Orthopedic
- 2-3 years of client training experience required
- Strong analytical skills including the ability to quickly identify trends and problems
- Must have a deep understanding of the Medical Billing Process and Industry Standard
- Strong understanding of our AdvancedMD product
- Knowledge of Medicare, Medicaid and commercial payer’s claims and appeals processing
- Ability to manage and fulfill client expectations
- Excellent communication and organizational skills with a customer service focus
- Understanding of third party vendor and clearinghouse processes
- Deep understanding of CCI edits and carrier specific coding edits for the above mentioned specialties.
- Knowledge/understanding of electronic claim files, data elements, and paper claim forms and requirements
