**Position not Remote**

Resurgens Surgical Center is looking for a motivated performer to join our Business Office team as a Revenue Cycle Specialist, We are looking for a top performer with an extensive knowledge of billing, collections and reimbursement of claims processing, insurance verification and scheduling.

This is a fast paced environment committed to producing the highest quality work for our surgery center. An ideal candidate will be personable and courteous.

JOB SUMMARY:

Successful candidate will possess outstanding multi tasking abilities, communication and teamwork as well as the ability to keep up in a fast paced working environment. The successful candidate should be able to demonstrate previous successful/positive customer service encounters or programs.

•  Generate and follow up on appeals where insurance has paid incorrectly Refile claims as needed to get claims to process for payment.
• Review denials and error messages in Zirmed and follow up promptly.
• Print the Advantx insurance aging reports weekly and review all accounts monthly.
• Call and check online for status of claims and documents in Advantx.
• Track and monitor any trending denials and notify BOM of common trends.
• Follow USPI policy which states to work each account every two weeks.
• Post all insurance comments in Advantx with detailed information on claim to include reps name, reference #, and phone numbers.
• Follow up on ALL insurance accounts and aging reports with collection status.
• Submit account adjustments weekly to BOM.
• Follow up on all correspondence within 24-48 hours, document using correct correspondence codes and file.
• Prepare Daily Deposit Log information for payment poster and BOM.
• Prepare and Mail patient statements.

OTHER DUTIES AND RESPONSIBILITIES:

• Familiar/working knowledge  with the Revenue Cycle and maintaining  financial buckets  (90 days, 120 days, 150days) *Familiar/working knowledge with finding trending issues, Track and monitor  why claims have not paid *Familiar/working knowledge with how managed care contracts are worked.

• Familiar/working knowledge of workers Comp or willingness to learn *Familiar/working knowledge of how to grammatical compose an appeal letter.

• Documenting accounts and consistent follow up on unpaid claims/accounts *Understanding insurance company  policies and procedures and using this information as ammunition to "fight' for claims".

• Determining  overpayments for insurance company and patients and preparing refunds *Understand how to determine allowed amounts for the procedure versus what was paid and what should be paid *Understanding all EOB's and the ability to explain to patients their financial responsibility *Generate and follow up on appeals where insurance has paid incorrectly Refile claims as needed to get claims to process for payment.

• Review denials and error messages in Zirmed/Waystar and follow up promptly *Follow up on ALL insurance accounts and aging reports with collection status.

• Ability to learn another function in the Business Office....cross training is mandatory *Two years experience in a doctor's office and or ASC/facility setting handling the revenue

KNOWLEDGE, SKILLS, QUALIFICATION and EDUCATIONAL AND /OR EXPERIENCE REQUIREMENTS:

• High School diploma or equivalent. One year of related experience and or training with ASC collections.
• Experience and or knowledge of Managed Care Contracts and the reimbursement of Workers Compensation entities.
• Understanding CPT, ICD-9, ICD-10 terminology.
• Basic math skills.
• Computer competency.
• Reasoning ability.

 USPI complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce.  If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date.  If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law. 

• Employed at a doctor’s office or ASC for minimum of 12 months
• Working Knowledge of Managed Care contracts and how they work
• Ability to verbalize the knowledge of Managed Care Contracts
• Working knowledge for manually calculating  insurance allowed amounts and patient responsibility
• Working knowledge and comprehension of EOB’s (Explanation of Benefits)