Minimum Qualifcations

Computer skills
Phone etiquette
Interpersonal skills
Insurance claims experience and reporting
Hospital and/or medical facility setting work experience

Essential Functions

Responsible for working and posting claims of patients covered under private and public plans while posting appropriate updates and statuses in the RCM system
Correcting patients' basic information, account status and insurance verification if incorrect
Daily insurance claim submission and follow-up
Regular claims status reports
Handles correspondence from insurance companies or patients and communicates out as appropriate via email, phone, portal
Correspondence, forms, and other materials to outside agencies
Research/process credits (recoupments and refunds) to insurance companies and patients as appropriate
Coding and policy change maintenance with insurance companies
Must be familiar with and remain updated on ICD-10, CPT codes, and medical terminology
Any other duties and tasks as assigned
Able to utilize and leverage Microsoft Office products (PowerPoint, Excel, Word, Outlook)
Experience with Modernizing Medicine practice management system and orthopedic billing and collections a plus

Education

EXPERIENCE / EDUCATIONAL REQUIREMENTS:

Graduate of four-year high school or equivalent (GED)

Experience

Three to five years healthcare RCM experience related to the described duties

U.S. Orthopaedic Partners

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RCM SPECIALIST