Qureos Mentor

Innovive Health

FLSA Classification: Non-Exempt
 Department: Finance
 Reports To: Sr. Manager of Revenue Cycle
 Direct Reports: N/A
 
POSITION SUMMARY: 
The Revenue Cycle Associate supports a high performing Revenue Cycle Department. The individual filling this position will be an ambitious hands-on problem solver and effective communicator that will support the achievements of the team. The role may include but is not limited to the following: following up on denials and collections, posting payments, or any other projects as needed.
 
RESPONSIBILITIES: 
<ul>
<li>Processes payments and denials within 48 business hours of receipt from insurers.</li>
<li>Documents denial reasons within the EMR using clear, concise language.</li>
<li>Reconciles the Cash Posting Journal/Deposits Report from each of our EMRs to the bank deposits.</li>
<li>Ability to comprehend and work with various payers’ remittance advices/explanations of benefits.</li>
<li>Understands the reason for denials or partial payments on remittance advices/explanations of benefits.</li>
<li>Research denials and partial payments to determine if further action is needed.</li>
<li>Research payers’ payment policies when necessary.</li>
<li>Contacts payers and patients to obtain payment on outstanding accounts.</li>
<li>Navigates through software systems efficiently.</li>
<li>Notifies appropriate parties if payment is not received or payer fails to respond.</li>
<li>Records information about financial status of accounts and status of collection efforts.</li>
<li>Prepares collections reports.</li>
<li>Requests timely adjustments and write offs.</li>
<li>Assists with related special projects and perform other related duties as assigned by management.</li>
<li>Adheres to all home health care regulations including CMS and multiple state Medicaid programs.</li>
<li>Adheres to agency’s policies and procedures.</li>
<li>Performs other duties as assigned.</li>
</ul>
COMPETENCIES: 
<ul>
<li>Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.</li>
<li>Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.</li>
<li>Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs workflows and procedures.</li>
<li>Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.</li>
<li>Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.</li>
<li>Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.</li>
</ul>
REQUIRED QUALIFICATIONS: 
<ul>
<li>Associate’s degree in business or 1-2 years of related work experience.</li>
<li>Intermediate level in Microsoft Office, Excel, Word, and Outlook</li>
<li>Ability to perform diversified clerical functions and intermediate level accounting procedures</li>
</ul>
PREFERRED EDUCATION AND EXPERIENCE: 
<ul>
<li>Previous experience using HealthWyse</li>
<li>Previous experience with the MassHealth Provider Online Service Center (POSC)</li>
</ul>
PHYSICAL DEMANDS AND OFFICE ENVIRONMENT: 
<ul>
<li>Occasionally required to stand.</li>
<li>Occasionally required to walk.</li>
<li>Frequently required to sit.</li>
<li>Continually required to use hands and fingers.</li>
<li>Occasionally required climb, balance, bend, stoop, kneel or crawl.</li>
<li>Occasionally required to lift/push light weights (less than 25 pounds).</li>
</ul>
TRAVEL REQUIREMENTS: 
<ul>
<li>Ability to travel locally by car to office(s), events, meetings, etc., as needed (approximately 5% or less of the time).</li>
</ul>
Innovive Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Revenue Cycle Associate

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Innovive Health

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Revenue Cycle Associate