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The Revenue Cycle Lead, reporting to the Revenue Cycle Manager, acts as a subject matter expert for all revenue cycle functions and activities. This position is responsible for ensuring compliance with third party payor requirements as well as all applicable state/federal laws and regulations.Only candidates able to commute to the jobs on-site location (Northbrook, IL) Monday through Friday 5 days a week will be considered. Remote work is not an option.Responsibilities Acts as subject matter expert for assigned revenue cycle areas, ensuring optimal revenue collection and patient satisfaction with the billing experience and ensuring compliance Performs RCA (Root Cause Analysis) to resolve problems affecting the revenue cycle and develop solutions to implement. Contacts insurance regarding claim status, denials, underpayments, and recoupments Read and understand insurance eligibility and benefits Research & resolve outstanding claim issues and patterns Submit Appeals for Denied Claims Submit Medical Records and other documentation requests to insurance Ability to work on 40+ denied claims per day on the phone and provider portals Ensures compliance with USAVC policies and procedures, health plan requirements, and federal and state laws and regulations Additional duties as assigned Requirements Bachelor's Degree plus 3 or more year's previous experience in medical collections, or an equivalent of experience and education, required Minimum of 2 years prior revenue cycle experience required Experience with Aetna, BCBS, UHC, Medicare, and Medicaid denials required Experience with multi state insurance denial collecting a preferred Familiar with provider portal eligibility and claim tools. Example: Availity, Navinet required Ability to read and understand insurance remittance including denial and remark codes required Ability to understand the remittance denial codes and get claims reprocessed required Strong personality and willingness to rebuttal with insurance claims representatives to overturn denials Exceptional customer service and phone etiquette Thorough understanding of physician billing practices and procedures, including knowledge of state, local and federal laws Strong knowledge of reimbursement rules and methodologies for both physician and ambulatory surgery billing Strong knowledge of Microsoft Excel (VLOOKUP and Pivot Tables) Only candidates able to commute to the jobs on-site location (Northbrook, IL) Monday through Friday 5 days a week will be considered. Remote work is not an option. Benefits Health Dental Vision 401K & match
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