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Revenue Cycle Specialist - Non-Medicare Billing - FT

Revenue Cycle Specialist - Non-Medicare Billing - FT

Job Description

If you want to make a difference in the lives of patients and family members consider Alive Hospice.
It’s been our privilege to serve middle Tennessee for more than 30 years. Our employees are committed to providing the highest quality end-of-life and palliative care available.

Alive Hospice is currently seeking an experience professional  Revenue Cycle Specialist to assist with non-Medicare billing


Primarily responsible for generating billing cycles, posting payments, and follow-up on claims to ensure timely payment.

1. Generates semi-monthly billing cycles in Allscripts and upload EMC file to Emdeon by the 5th business day following the end of the billing cycle.
2. Responsible for or back up for commercial insurance, self-pay, Residence Room & Board (R&B) billing. Review claims prior to submission for compliance with insurance regulations.
3. Reviews and faxes NH R&B invoices. Maintains a good working relationship with nursing home billing staff. Ensures patient liability in Allscripts updated with Tenncare website. Submits final invoices to RC Manager for approval and forwarding to A/P for payment.
4. Back-up for EHB/CTI compliance review. When necessary maintains spreadsheet of outstanding and noncompliant records. Reports to Director of Revenue Cycle.
5. Post all non-medicare payments and balance with daily deposits. Ensures proper payment received per MCO contract. Follow up on incorrect, partial payments or unpaid claims.
6. Responsible or back-up for entry of physician visits prior to billing. Audits physician charges with notes prior to submission of claims.
7. Reviews initial diagnosis codes to ensure compliance with hospice CTI and billing regulations. (If applicable in job duties assigned)
8. Copy incoming room & board and self pay checks and forward to AP Clerk for daily deposit. Process credit card payments and credits.
9. Follow up on outstanding claims per aging report over 60 days. Documenting collection efforts in Allscripts. Submit appeals when necessary on denied claims.
10. Submit write off requests with documentation after all collection efforts exhausted to Director of Revenue Cycle.
11. Notifies the Director of Revenue Cycle of any problems with patients’ claims, or insurance companies.
12. Initiate projects with insurance specific payment issues.
13. Responsible or assists with DOD corrections with vital records and Social Security office.
14. Backup status change duties of Eligibility Specialist when needed. (If applicable in job duties assigned)
15. Assists other Revenue Cycle Staff as needed to meet department goals.
16. Other duties may also be assigned.

Job Requirements


High School diploma required. One year college or technical school: one to three years related experience or equivalent combination of education and experience. Strong preference for candidates with extensive background in medical billing/collections.

Job Snapshot

Employment Type Full-Time
Job Type Health Care, Admin - Clerical
Education High School
Experience At least 1 year(s)
Manages Others No
Industry Healthcare - Health Services, Not for Profit - Charitable
Required Travel Not Specified
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Revenue Cycle Specialist - Non-Medicare Billing - FT

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