Rcms Associate I

2 months ago


Vadodara Gujarat, India Qualifacts Systems, Inc. Full time

Job Description:
1. Accurate Payment Posting:

- Accurately post all insurance and patient payments by line item using medical claim billing software.

2. Zero Errors in Claims Submission:

- Ensure all claims are submitted with zero errors to minimize rejections and optimize revenue cycle efficiency.

3. Claims Completeness and Accuracy Verification:

- Verify the completeness and accuracy of all claims prior to submission to insurance companies.

4. Meeting Payment Posting Deadlines:

- Meet deadlines for posting payments to ensure timely reconciliation of accounts receivable.

5. Interpretation of Explanation of Benefits (EOBs):

- Read and interpret insurance EOBs to reconcile payments, denials, and adjustments for accurate posting.

6. Attendance at Staff Meetings and Educational Sessions:

- Regularly attend monthly staff meetings and participate in continuing educational sessions to stay informed about industry updates and best practices.

7. Additional Duties as Requested:

- Perform additional duties as requested by the supervisory or management team to support departmental objectives.

8. Data Entry for Payment Posting:

- Enter necessary information for insurance claims, including patient demographics, insurance ID, diagnosis and treatment codes, and provider information, ensuring completeness and accuracy.

9. HIPAA Compliance:

- Follow HIPAA guidelines and maintain patient confidentiality when handling sensitive information during payment posting processes.

10. Patient Benefits Eligibility Verification:

- Verify patient benefits eligibility and coverage as needed to ensure accurate payment posting.

11. Data Security and Integrity:

- Maintain the security and integrity of practice data being worked on to protect sensitive information and comply with regulatory requirements.

12. Revenue Cycle Performance Analysis:

- Obtain a clear view of revenue cycle performance through accurate payment posting and data analysis.

13. Policies and Procedures Development:

- Develop exhaustive policies and procedures for write-offs and adjustments to ensure consistency and compliance in financial transactions.

Qualifications:

- High school diploma or equivalent; associate's or bachelor’s degree in healthcare administration, Commerce/Arts or related field preferred.
- Minimum of 1-2 years of experience in medical billing or revenue cycle management, with a focus on payment posting.
- Strong attention to detail and accuracy in data entry and payment reconciliation.
- Knowledge of medical billing software and electronic health record (EHR) systems.
- Familiarity with insurance EOBs and payment reconciliation processes.
- Understanding of HIPAA regulations and patient privacy requirements.
- Excellent communication and interpersonal skills.
- Ability to work independently and collaboratively in a fast-paced environment.
- Commitment to meeting deadlines and achieving departmental goals.

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.



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