foodsmart - Revenue Cycle Specialist
Requirements
• 1-3 years of experience in medical billing, claims submission, or denials management • Working knowledge of claim lifecycle basics (CMS-1500/837 claims, CPT/ICD-10 coding, EOBs/ERAs, common denial reason codes) • Comfort with Google Suite and Excel (sorting, filtering, and ideally pivot tables and VLOOKUPs) • Strong written and verbal communication skills, ideally also with comfort working with health plans to resolve payment issues • Experience with EMR or RCM software (i.e. Candid) is a plus • Experience with Medicaid or Medicare billing is a plus • Experience with registered dietician, nutrition services and/or food billing is a plus
Responsibilities
• Process and submit claims: Prepare and submit claims to health plans accurately and on time, and keep the work moving through the billing cycle. • Work denials and rejections: Research denied and rejected claims, identify the root cause, make corrections, and resubmit. Flag recurring patterns to the team so we can fix issues at the source. • Follow up on reimbursement: Monitor claim status, follow up with health plans and RCM partners, and help resolve payment issues. • Support reporting and month-end close: Help prepare claims and billing reports, and keep documentation clean and up to date. • Take on ad hoc projects: Jump in on investigations, one-off cleanups, and special projects as they arise. Examples include researching a batch of aged claims or digging into a payer-specific issue. • Partner across teams: Work with finance, product, and engineering to share what you’re seeing in the data and in day-to-day claims, and help test and give feedback on process or system improvements. • Support the patient and health plan experience: Help with billing communications and questions so patients and health plans have a smooth experience. • A clear communicator and a good teammate • Detail-oriented, with an analytical streak • Comfortable switching priorities when something urgent comes up • Curious and eager to learn, and happy to ask “why does it work this way?” • Able to work independently on assigned work and know when to pull in help
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