Account Resolution Specialist

Job Details

Description

SUMMARY:

Under the general supervision of the Billing Manager, this position is responsible for the billing and collection of selected claims for Rhode Island Medical Imaging. This position also assists patients with questions regarding coverage and payment issues. The position is a key component of the cash flow for the institution.

Schedule

• Monday-Friday 8:30AM-5:00PM
• This will be a hybrid position once the training/onboarding period has successfully been completed! Training will be completed on-site at our corporate office in Warwick, RI.
  
  

Principal Duties And Responsibilities

• Understand the elements associated with completing the HCFA 1500 billing form for payor(s). Understand and resource billing guidelines for each payor; stay informed on related changes.
• Recommend modifications to RIMI’s billing system based on knowledge of billing guidelines.
• Is familiar with CPT codes, HCPC codes, and ICD-10 codes. Use department and payor resources to ensure accurate and complete billing.
• Complete billing and collection duties in a timely and accurate fashion.
• Take initiative and alert Management to possible issues or concerns.
• Ensure that all claims are in compliance with the respective carrier rules as well as HIPAA and federal compliance regulations.
• Review monthly accounts receivable aging report(s) for assigned payor class and take action to resolve.
• Address outstanding accounts and credit balances in a timely fashion.
• Assist patients with questions regarding their bills in an efficient and professional manner.
• Crosstrain and assist other team members when directed by Management.
• As needed, enlist the help of the Billing Manager or Supervisor to ensure that accounts remain collectable.
• Stay informed on all insurance changes regarding policy and coverage guidelines.
• Maintain professionalism at all times and adhere to all company policies and procedures.
• Consistently apply the corporate values of respect, honesty, fairness, and constant pursuit of excellence in improving local patient health status through the provision of customer-friendly, geographically accessible, and high-value services within the environment of a diagnostic imaging company.
• Ensure that all interactions are in compliance with HIPAA/federal and state compliance regulations.
• Participate in meetings as requested.
• Perform other duties as assigned.
  
  

Basic Knowledge/Skills

• Must have knowledge of third-party billing requirements.
• Bilingual Spanish preferred.
• Computer skills and ability to operate modern office machinery.
• Ability to work in a team environment.
• Excellent verbal communication and telephone skills.
• Excellent interpersonal skills.
• Ability to multitask and prioritize.
• Ability to adapt, in a timely manner, to changes in billing/collecting rules as defined by insurance companies and/or Management.
  
  

Experience

• Minimum one year of third-party billing experience.
  
  

Education

• High school diploma or equivalent.
• Additional courses in insurance billing, computer basics, and medical terminology preferred.
  
  

Physical Demands

To perform this job successfully an individual must be able to perform each essential duty satisfactorily. This description is not intended to be a complete statement of the position, but rather to act as a guide to the general work to be performed. The requirements are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The individual's competencies and customer requirements impact the actual role performed. Prolonged periods of repetitive sitting and standing at a desk and working on a computer. Must be able to perform all essential duties without restriction.

Join an award-winning organization! With 16 private, state-of-the-art medical diagnostic imaging facilities, join the team that has been providing Rhode Island with imaging excellence for over 80 years! The American College of Radiology has named RIMI one of the first outpatient diagnostic imaging Centers of Excellence in the country and the first in Rhode Island.

RIMI offers best-in-class benefits to eligible employees including multi-tiered health plans, flexible spending accounts, generous paid time off, 401(k) plan with profit sharing component, uniform reimbursement, company "swag," yearly reimbursement for continuing medical education, educational assistance (reimbursement) program, student loan repayment program, and career development opportunities. Enjoy competitive pay and all in our innovative culture that consistently provides the highest levels of quality, safety, technology, and patient care.