- Performs regular payment variance analysis to identify contracted insurance under & over payments. Presents results in a standard reporting package and manages all follow up activity with payers.
- Develops and monitors a mechanism that tracks the performance of managed care relationships.
- Builds & maintains insurance and patient charge masters aligned with CMS published rates.
- Builds & maintains insurance allowable fee schedules.
- Builds & maintains standardized master payer tables including financial classes. Publishes payer/provider participation matrices.
- Coordinates communication of all systems changes to impacted stakeholders.
- Provides overall revenue cycle reporting and analytics support on monthly and ad hoc basis.
- Audits patient accounts as needed to validate data.
- Analyzes and trends denials; reporting recommendations to reduce/prevent future denials.
- Performs other related duties and works on special projects as requested by senior management.
- Strong comprehension of physician medical practice revenue cycle and reimbursement concepts. Full revenue cycle knowledge is preferred.
- Possesses advanced Excel expertise to include pivot tables, formulas, V-look up, & other functions.
- Expertise with quantitative decision making, data modeling, trending, and interpretation.
- Dependable and able to balance multiple priorities and accomplish tasks under tight deadlines.
- Excellent oral and written communication skills.
- Ability to exercise initiative, judgment and decision-making skills.
- Ability to work independently or as part of a team.
- Knowledge of CMS regulatory standards and general commercial payer billing guidelines.
- Full-Time
- Monday – Friday 8am-5pm
- The position is remote, the candidate must reside in Alabama, Florida, or Georgia
- College degree, or High School Diploma with equivalent work experience
- Working knowledge of ICD-10, CPT and HCPCS coding, fee schedule reimbursement methodology, and regulatory requirements for provider coding and reimbursement
- Working knowledge of key coding concepts, such as CPT modifiers, surgical packages, medical record documentation requirements, and multiple procedure guidelines
- Computer skills and proficiency in internet search functionality is required
- Proficient in analyzing statistical data & creating KPIs
- General understanding of professional fee billing processes and procedures
- Ability to operate basic office equipment and multi-line telephone system
- Knowledge of medical billing software
- Expert in Microsoft Office Suite (Outlook, Word, Excel, PowerPoint, Teams)
- Medical, Dental, and Vision available after 30 days of hire
- Short-term disability and life insurance, and many ancillary options.
- 401k available after 90 days of hire
- Paid time off
- Discounts on services
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AQUA Dermatology - Palm Beach Gardens, United States - Riverchase Dermatology
Description
AQUA Dermatology is Florida's largest and most comprehensive full-service skin care provider in the Southeast with additional partner practices throughout Alabama and Georgia, offering medical, surgical, and cosmetic dermatology, plastic surgery, vein care, and radiation oncology.The Physician Revenue Cycle Reimbursement Analyst (remote) role will perform various functions centered around data analytics and reporting, charge master & fee schedule management, and maintaining overall revenue integrity across multiple state markets.
Essential Functions
Competencies
POSITION TYPE AND EXPECTED HOURS OF WORK
Education and Experience:
Communication – Excellent oral communication skills; ability to communicate
Work Style - Must be able to work well independently but ask for help when needed. Ability to analyze and interpret information, ability to interact and decipher information telephonically and electronically.
Benefits
About the Company
Founded in 1998, AQUA Dermatology is the Southeast's premier dermatology practice with over 100 locations throughout Alabama, Florida, and Georgia. Our established practices and experienced physicians offer patients the highest quality outcomes and an exceptional patient experience. From common rashes to skin cancer treatments, and plastic surgery procedures to an array of vein treatments, no case is beyond our experience and expertise
