RCM Billing Specialist

Summary

Slocum Center for Orthopedics and Sports Medicine is seeking an RCM Billing Specialist to manage the financial lifecycle of patient care. The role verifies patient coverage, submits and tracks claims, resolves denials, manages accounts receivable, and communicates with patients, providers, and internal departments regarding billing concerns.

Responsibilities

• Prepare, review, and submit clean, error-free claims to insurance payers
• Follow up on denied or rejected claims to secure reimbursement
• Process claims showing amounts billed to insurance companies and to patient and miscellaneous adjustments
• Talk with patients about their Slocum clinic or ASC medical bill, via phone, in person or patient portal
• Manage patient accounts, calculate intake costs, and arrange payment options
• Answer patient questions regarding their Slocum statements in person, via phone or patient portal
• Refund over payment of claims either to the patient or the insurance company
• Compute total bills showing amounts billed to insurance company and to patient
• Verify patient’s coverage via website or telephone and to obtain information concerning extent of benefits
• Telephone, write or message via website companies with unpaid insurance claims to obtain settlement of claim
• Verify OHP Line Finder Code
• Work denied insurance claims via letter, website or call
• Manage the private insurance A/R
• Create estimates via Experian as well as manually as needed
• Communicate cross-functionally with providers and other Slocum departments regarding patient questions or billing concerns

Skills

• Strong knowledge of medical coding (ICD-10, CPT), terminology, and insurance regulations
• Billing and/or Coding experience
• Healthcare experience
• Experience working with Electronic Health Records
• Be able to read and understand digital and paper insurance Explanation of Benefits
• To be professional and courteous
• Able to multi task
• Prioritize work load daily, weekly and monthly
• Have high accuracy and efficiency
• Communicate clearly, concisely and courteously via phone, email and in person
• Medical insurance knowledge and background required
• High school diploma or GED or equivalent experience and training required
• Previous experience as an RCM Billing Specialist or related experience with patient billing, collections, and/or coding
• Previous experience working with Electronic Health Records
• Qualified candidates must reside in Oregon

Qualifications

Must Haves

• Strong knowledge of medical coding (ICD-10, CPT), terminology, and insurance regulations
• Billing and/or Coding experience
• Healthcare experience
• Experience working with Electronic Health Records
• Be able to read and understand digital and paper insurance Explanation of Benefits
• To be professional and courteous
• Able to multi task
• Prioritize work load daily, weekly and monthly
• Have high accuracy and efficiency
• Communicate clearly, concisely and courteously via phone, email and in person
• Medical insurance knowledge and background required
• High school diploma or GED or equivalent experience and training required
• Previous experience as an RCM Billing Specialist or related experience with patient billing, collections, and/or coding
• Previous experience working with Electronic Health Records
• qualified candidates must reside in Oregon

Benefits

• This is a remote position after 90 days of in-office training.