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Revenue Cycle Specialist
Full/Part Time: Full Time
Location/Affiliates: The Mount Sinai Hospital
Department: 518 - Credit
Requisition Number: 13-1530696
Under the supervision of the PFS manager and or Senior Director, responsibilities include various aspects of receivable management for the Patient Financial Services (PFS) Department.
Collect, analyze and report on data within the Patient Accounting System(s). Review specific cases, re-bill and follow-up with third party payers for accounts receivables. Candidate must have the ability to work in a "stratified process environment."
Understand hospital based billing for all inpatient and outpatient encounters.
Reviews and analyze the Commercial and Blue Cross Trial Balance for aged accounts that have not been resolved. Analyze accounts and take next steps to drive accounts to closure.
Contract compliance-research, review and reprocess previous disposition accounts for additional revenue. This includes but is not limited to zero accounts, carved out contract service items and/or rate adjustments.
Reconcile patient accounts receivable deposits including posting and balancing.
Work on ALL TRAC CDM buckets.
Update LMRP, fee scheduled and CDM record in Eagle system.
Understanding third party contracts and translating the salient terms into appropriate action(s). Knowledgeable with transplant service/billing guidelines.
Retroactive rate adjustments - re-bill, adjust and/or void claims.
Prepares weekly excel spreadsheets.
Prepares for weekly TRAC listings; focus meet, payer meet(s) etc.
Various re-bill projects.
Accounts receivable adjustments; credit balance review and preparation.
Patient Accounts System (Eagle) updates - review and reprocess accounts when PFS systems updates are made.
Work all assigned listings from Patient Accounts System.
Prepare listings for third party payers - listings to include open receivables on delinquent accounts receivables.
Review accounts through various third party websites.
Coordinate with outside party's for account validation.
Communicate and work with inter/intra departments.
Track specific payer outcomes.
Attend seminars and workshops as required.
Ability to adapt to any new systems implemented.
All other assignments assigned by the manager, director and/or vice president.
Associate's Degree. Bachelor's degree preferred.
Experience in a Medical practice business office or patient accounts preferred.
Medical/hospital accounts receivable (hospital/third party) experience helpful.
Excellent analytical, problem solving, and interpersonal and communication skills.
Must be able to work independently and on a team.
Knowledge of Microsoft Excel, Microsoft Word, Internet, Omnipro. Premis, Trac/On-Trac, Cirius and Eagle applications preferred.
Mount Sinai Medical Center is an equal opportunity/affirmative action employer. We recognize the power and importance of a diverse employee population and strongly encourage applicants with various experiences and backgrounds. Mount Sinai Medical Center--An EEO/AA-D/V Employer.