United States onlyOverview
The Revenue Cycle Management Analyst III is responsible for analyzing, researching and resolving issues related to the creation and submission of paper and electronic claims. Works with the Business Systems Department to create effective clearinghouse edits which respond to errors generated from electronic claims submissions. Monitors claim errors until resolved. Identifies opportunities for new edits based on billing analysis.
Responsibilities
- Retrieves, researches and resolves all front-end rejections from clearinghouse vendor. Investigates and resolves carrier edits / error within the billing system.
- Makes necessary corrections and re-bills the claim timely.
- Within established Standard Operating Procedures, clearly and completely document all information relevant to claim error reviews and corrections in the patient accounting system consistent with permanent legal records.
- Interacts and communicates with Provider Enrollment to resolve outstanding issues. Coordinates with the PE Department to ensure re-bills are sent for providers following enrollment completion.
- Notifies the Collections Management Team of any unusual or large volume payer trends / denials.
- Works with updating insurance information for claims that need to be re-billed.
- Performs other job-related duties within the job scope as requested by Management of Patient Accounts.
**Eastern Standard or Central Time Zone***
Qualifications
Education/Experience:
- High school diploma or general education degree (GED) required.
- College degree preferred.
- 5 years Revenue Cycle Management experience required.
Skills/Experience:
- Strong verbal and written commuuciation skills.
- Ability to effectively present information and respond to questions from customers and vendors.
- Ability to read, analyze, and interpret general business documents, technical procedures and governmental regulations.
- Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
- Ability to define problems, collect data, establish facts, and draw valid conclusions.
- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Ability to calculate figures and amounts such as discounts and percentages.
Software:
Basic Microsoft Office experience.
Benefits and Compensation
Benefits for Full Time employees and qualified dependents:
- Medical, Prescription, Dental, Vision Insurance
- Progyny Fertility Benefits
- Livongo Diabetes Management
- Teladoc Health and Second Opinion Services
- Smart Shopper
- 401(K) Thrift Program & Sharing Plan**
- Employee Stock Purchase Plan (ESPP) – 15% discount*
- Basic Employee; Spouse; Child Life Insurance
- Accidental Death and Dismemberment (AD&D)
- Employee Optional Life and AD&D
- Short & Long Term Disability
- Pre-Tax Health Savings Accounts (HSA)
- Employee and Dependent Flexible Spending Account (FSA)
- Family Medical Leave Act (FMLA)**
- Parental Leave Benefit
- Sick Pay Bank
- Employee Assistance Program (EAP)**
- Group Aflac Policies
- Identity Theft Protection
- Employee Charitable Fund
- Care.com
- Various Discount Programs
*Part Time Regular employee classifications also receive this benefit
**Available to part-time regular and part-time casual employees aged 21 and over
About Us
Pediatrix Medical Group is one of the nation’s leading providers of highly specialized health care for women, babies and children. Since 1979, Pediatrix has grown from a single neonatology practice to a national, multispecialty medical group. Pediatrix-affiliated clinicians are committed to providing coordinated, compassionate and clinically excellent services to women, babies and children across the continuum of care, both in hospital settings and office-based practices. The group’s high-quality, evidence-based care is bolstered by significant investments in research, education, quality-improvement and safety initiatives.
Please Note: Fraudulent job postings/job scams are becoming increasingly common. All genuine Pediatrix job postings can be found through the Pediatrix Careers site: www.pediatrix.com/careers.
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Pediatrix is an Equal Opportunity Employer
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
