Revenue Cycle Associate
Summary of Major Responsibilities
The Revenue Cycle Association (RCA) position, while having a specific focus, is designed to be highly cross-functional. An RCA will initially specialize in one of the following areas:
· Data entry, processing, and resolution of assigned errors and rejections related to the submission of billing files
· Work closely with other members of the Customer Care Center, patients, payors, and physicians to ensure missing or incorrect information is resolved timely.
· Post payments and adjustments timely and accurately in accordance with department guidelines.
· Follow-up on unpaid claims, determine, and perform the appropriate next step – contact insurance payors and patients, file appeals, and ensure denials are resolved timely.
Essential Duties and Responsibilities
- Complete position responsibilities within the appropriate time frame while adhering to quality standards.
- Ensure compliance with all Company procedures and guidelines including, but not limited to, Code of Business Conduct and Ethics.
- Stay current with relevant medical billing guidelines.
- Work with others in a spirit of teamwork and cooperation.
- Identify issues with billing, coding, and reimbursement related to payments and communicate these to supervisor.
- Provide ad-hoc support as necessary within the department (i.e. special projects, provide support due to outages/high volume).
- Complete other duties as assigned.
· Perform patient insurance eligibility verification for all claims requiring follow-up.
· Data entry and corrections in system including updates to permanent patient demographics.
· Processing and resolution of errors, rejections, and denials related to the submission of billing files.
· Research missing or erroneous information on orders including outreach and identification of unknown payors.
· Timely and accurately post a high volume of patient, insurance and/or Medicare payments both electronically and manually.
· Reconcile all batches to the deposit on a daily basis.
· Timely and accurate posting of all approved adjustments and refunds of overpayments.
· Process resubmissions and appeals for denied claims.
· Review Accounts Receivable Reports to identify problematic accounts/payors trends.
· Route write off requests for any uncollectible Accounts Receivable.
Mandatory Skills & Qualifications:
- Excellent written and verbal English communication skills, including appropriate telephone etiquette.
- Demonstrated ability to read and comprehend written instructions.
- A positive attitude and excellent interpersonal skills with the ability to interact and build strong working relationships with customers and peers at all levels of the organization.
- Disciplined, self-motivated, and reliable: able to stay focused on a task and work independently; motivated to perform quality work; diligent about arriving to work on time and completing tasks that are assigned in a timely manner.
- Professional: conducts self in a professional manner in all interactions with members of the Exact Sciences team, clients and associates.
- Ability to work in a team environment and adapt to changing workload and circumstances effectively; able to respond to new information quickly.
- Ability to operate telephone system, fax machine, printer, scanner, personal computer, photocopier.
- Overtime initiative when needed.
Necessary Education & Experience:
- High School diploma or GED
- Minimum 1 year of expereince in medical or insurance billing field or related associate's degree/medical billing certification
- Demonstrated experience working in Microsoft applications (Word, Outlook, Excel, PowerPoint).
- Bachelor's degree in related field.
- Demonstrates initiative and willingness to continuously improve processes.
- Two to four years of experience in medical provider setting or billing department within the health care industry.
- Knowledge of health insurance terminology, governmental payers, managed care and insurance organizations.
Physical Requirements and Working Conditions:
- Position requires work in normal office environment.
- Work is generally sedentary in nature but may require standing and walking for up to 10% of the time.
Exact Sciences is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to age, color, creed, disability, gender identity, national origin, protected veteran status, race, religion, sex, sexual orientation, and any other status protected by applicable local, state or federal law. The Company’s affirmative action program is available to any applicant or employee for inspection upon request.
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