[Hiring] Revenue Cycle Specialist, AR Credit Resolution @Weill Cornell Medical College

Role Description

Responsible for carrying out all functions related to Account Receivable review and Credit Resolution.

• Utilizes the Credit Work Queues to analyze and validate credit transactions across all departments for proper resolution.
• Works dedicated project-based spreadsheets.
• Assists with the development and implementation of strategies and procedures that will reduce credit balances and maximize credit resolution efficiency.
• Responds to payer requests for additional information and validation of coverages.
• Responds to other credit balance related inquiries.
• Processes correspondence items related to denials, recoupment, and refund request documents across all patient accounts.
• Submits letters for payer recoupment extensions.
• Reviews accounts receivable for credit, adjustment posting discrepancies, and determines appropriate action required to resolve variance.
• Researches credit balance inquiries and assists in gathering required documentation for resolution from EPIC, Banking, and Insurance portals.
• Reviews registration, demographic, and insurance eligibility issues to determine allocation of payments and credits.
• Responsible for notating and reporting inconsistent and invalid financial transactions.
• Monitors credit patterns and alerts manager to deviations.
• Processes all incoming returned refund checks across all departments and assesses proper resolution.
• Contacts payers regarding discrepancies and appeals of requested refunds.
• Assists in training current and new employees on the use of systems and departmental policies and procedures.
• Assists in the audit of the new employees and provides feedback.
• Maintains established institutional and department policies and procedures, objectives, and quality & safety standards.
• Respects and adheres to rules and regulations regarding patient confidentiality, HIPAA, and handling PHI (Privileged Health Information).
• Performs other job-related duties as required.

Qualifications

• High School Diploma.
• College degree is preferred.
• Approximately 3 – 5 years of medical billing experience.
• Demonstrated knowledge of medical terminology.
• Demonstrated knowledge of third-party reimbursement.
• Previous related experience in an office setting.

Requirements

• Demonstrated ability to function independently and exercise independent judgment.
• Demonstrated strong communication and interpersonal skills; ability to interact with multiple constituencies and exercise "people skills".
• Demonstrated proficiency with MS Office Suite and database applications.
• Demonstrated organizational skills and ability to pay close attention to detail.
• Demonstrated critical thinking and analytical skills.
• Demonstrated ability to multi-task and prioritize in a fast-paced environment.
• Demonstrated ability to remain focused despite frequent interruptions.
• Ability to treat confidential information with utmost discretion.
• Ability to exercise standards of professionalism, including appearance, presentation, and demeanor.
• Demonstrated ability to work effectively in a collaborative manner with all departmental faculty and staff, as well as other institutional representatives.

Working Conditions/Physical Demands

• Position requires mandatory overtime to meet departmental requirements at month end.