Rcms Associate Ii

2 days ago

Vadodara Gujarat, India Qualifacts Systems, Inc. Full time

Job Description:
Key Responsibilities: 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 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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