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Patient Care Specialist

Company: XRHealth
Location: Brookline
Posted on: January 9, 2022

Job Description:

Principal Duties and Responsibilities:

  • Obtaining, verifying and documenting all claim and insurance benefit information.
  • Submitting accurate/clean claims to insurance carriers for payment, including coordinating benefits with multiple insurance carriers.
  • Reviewing claim payments for proper reimbursements; appealing underpaid or denied claims.
  • Telephone, mail, and email communication with insurance adjusters and attorneys regarding open or denied claims.
  • Negotiating settlements with insurance adjusters and/or attorneys.

    Review patient insurance, billing & collections, and data processing to ensure accurate patient billing and efficient account collection.
    • Review the coding work queues accessing the accuracy of CPT and ICD-10 coding to ensure compliance, correcting issues & releasing bills for processing.
    • Establish and implement billing policies and procedures, as well as research, recommend and implement best business practices.
    • Maintain up-to-date expertise and knowledge of healthcare billing laws, rules, regulations and developments necessary for the organization to make informed business decisions and assure compliance with applicable rules & regulations.
    • Act as a liaison between the billing staff and Clinicians / Providers regarding billing issues and education.
    • Informing and collaborating with internal/external parties on daily issue resolution, participating on project work groups focused on process and/or technical improvements
    • Assisting with requests for billing information and inquiries from Patient Relations/Customer Success regarding XRHealth professional billing issues.

      • Bachelor's Degree Preferred
      • Knowledge with CPT & ICD-10 coding requirements.
      • Current or very recent Revenue Cycle experience
      • Current or very recent experience implementing policies and procedures
      • Must have extensive knowledge of relevant billing regulations and insurance regulations, healthcare coding & reimbursement systems.
      • Experience in Telehealth and/or Rehabilitation Outpatient setting is strongly preferred.
      • Ability to prioritize and manage multiple responsibilities, manage projects, demonstrate leadership and cultivate strong working relationships with Senior Management and others throughout the organization.
      • Ability to review clinician documentation & assist them to meet requirements
      • Working knowledge of Athena (HER/Billing) preferred.

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Keywords: XRHealth, Brookline , Patient Care Specialist, Other , Brookline, Massachusetts

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