Revenue cycle specialist (floater) specialized workflow assistance team (swat) - 100% remote
About msm
Msm is your indispensable partner for better healthcareMedical specialties managers emboldens medical group practices to reach their fullest potentialFounded in 1985, we deliver meticulously personalized services in practice management, revenue cycle management and technology, giving physician groups the seasoned strategy and robust support that enable them to scaleWe act as a transparent extension of our clients’ practices, generating measurable outcomes with superlative people and cutting-edge technologyWe are your established management services organization (mso) with over 35 years of experience in the business of healthcare that consider our people our biggest and best asset!
About the role:
Medical specialties managers (“msm”) is looking for a knowledgeable and dynamic revenue cycle specialist (floater) to join our rcm swat teamThis is a specialized, high visibility role that will support all departments within the revenue cycle operations team including: data & claims quality, customer service, payment posting, insurance follow-up, contract & credentialing, medical coding, and admin supportYou will “float” between projects throughout these areas and play a key role in the day-to-day functions of the revenue cycle management departmentYou must have experience in revenue cycle, insurance, payment posting and post claim follow-up work (multiple payors across multiple states)This unique position is an opportunity for a detailed, self-motivated, organized individual to support these departments and provide value to the greater organization.
What you’ll do
Team responsibility will vary depending on department needs and backlogsSome common projects are outlined below but is not all inclusive.
Work with multiple payors, across multiple states and various information systems including our proprietary in-house system practice vision
Interpret and understand basic accounts receivable (a/r) metrics as well necessary steps to review and act on unpaid a/r
Review and resolve accounts in global interface engineAction may include but not limited to updating insurance, authorization, creating accounts
Professionally resolve inbound customer service calls from patients in the call queue
Review outstanding patient balances related to payment plans, no statement holds, and special handling accounts and take appropriate action(s).
Assist the revenue cycle team with contracting and credentialing concerns that impact the claims process.
Interface with clients to obtain applicable documentation required to credential providers and facilities with contracted health plans and load into the credentialing database as well as in the council for affordable quality healthcare (caqh) database.
Assist with building health plan rates and fee schedules into the contracting database.
Research and resolve coding related denialsSearch for information in cases where the coding is complex or unusualCorrect claim scrubber errors and update workflow logs.
Review and interpret payment information from the eob (explanation of benefits) to accurately apply payment and adjustment when necessaryRetrieve eob’s from payer sites for clients that have an eft deposit with no electronic remit and add them to the payment intake tool for posting.
Review and interpret over payment requests and determine appropriate next steps.
Prepare and mail claims to the insurance carriers and or upload documents to other billing platform.
Download generated appeal letters from insurance follow-up through a billing shared application and attach any required documentation, such as clinical reports, eob’s, etc.
Review, respond to, and complete priority follow-up requests.
**additional projects/tasks as assigned
What you’ll need
Minimum of the following: 4-5+ years in at least three of the following areas: medical billing, claim clearinghouse errors, medical coding, payment posting experience, payor enrollment, insurance follow up and a call center/customer service.
Ability to interact with providers and clients in a professional and pleasant manner
Forward thinking attitude
Ability to identify problems and issue and provide solutions
Desire and ability to work collaboratively with team members and communicate effectively with all levels of staff
Technical aptitude and proven track record of learning new systems
Strong written and verbal communication skills
Critical-thinking, reasoning, problem-solving skills and adaptability to change an absolute must
Follow through, time-management and prioritization imperative
Excellent team-work and customer service skills
Tech savvy, with ability to learn new systems
Ability to maintain a high level of detail and confidentiality
10 key, data entry skills and proficiency in microsoft excel and word required
Ability to interpret explanation of benefits (eob)
Understanding of payer policies
Bachelor’s degree in healthcare administration, or related area preferred
Healthcare experience required
Cpc certification required a plus
Why msm?
Awarded the orange county register’s top workplace 11 years running
Competitive salary and bonus potential
100% company paid medical and dental coverage for select plans
Company sponsored retirement plan
Pto and company paid holidays
Awesome workplace culture
Volunteer and philanthropic opportunities
About medical specialties managers (“msm”)
At medical specialties managers, inc., we believe that a company is only as strong as the people it employsWe have a casual, enthusiastic, dynamic and collaborative working environmentWe are a “flat” organization with an open-door policyWe are continuously focused on creating a positive and cooperative atmosphereWe strongly believe that practicing mutual respect in our relationships is beneficial for employees and employers alikeWe make efforts to support our staff in achieving their personal and career goalsTo that idea, we believe promoting from within creates a foundation of employees that are motivated, dedicated and highly knowledgeableProviding our employees with an outstanding work environment, competitive compensation, bonus plan and an exceptional benefits package has resulted in being awarded “the orange county register’s top workplaces” honor for 11 years running.
Providence stJoseph health
In january 2017, the company was acquired by providence stJoseph healthThe future of the organization is bright as msm is the exclusive practice management and revenue cycle management provider to medical group practices associated with providence stJoseph healthProvidence stJoseph health is a leading healthcare organization created by the merger of providence health & services and stJoseph health with the goal of improving the health of the communities it serves, especially those who are poor and vulnerableThe organization has over 100,000 caregivers serving over 50 hospitals, 800 clinics, and a comprehensive range of services across alaska, california, montana, new mexico, oregon, texas, and washington.
Medical specialties managers, incParticipates in e-verifyWe provide the social security administration (ssa), and, if necessary, the department of homeland security (dhs), with information from each new employee`s form i-9 to confirm work authorization.
