Revenue Management Specialist

Spartanburg Regional Healthcare System

Job Description

Job Summary
The AR management specialist works with unique department billing/collection functions to assure accounts are managed accurately and timely. Responsibilities will vary based on department need. Duties to include-
Responsible for research and resolution of all outstanding patient and insurance credit accounts, any additional A/R management research and account updates required to ensure claims are filed to the appropriate carrier or posted correctly.
Processing of all refunds or credit reversals in a timely manner as defined within the departmental credit/refund policy/procedures.
Responsible for all government monthly credit reporting preparation and requirements
Responsible for accurate charge capture, charge review, claim edits, posting to the AR system and resolution of all charge edits.
Responsible to handle all denials related to charge capture for improved integrity of charge capture
Responsible to accurately update patient demographics, insurance registration information, verification of insurance, etc.
Responsible for the consolidation of duplicate guarantor/patient accounts within the AR management system in an accurate/timely manner.
Responsible for the review and processing of Accounts Receivables reports to ensure revenue integrity. Reporting trends identified during the analysis.
Assist with payer/physician credentialing and system table management.
Responsible for electronic remittance, eligibility and claims agreements to insure the proper processing of electronic transactions, electronic remittance requirements and other payer requirements for billing.
Responsible for all account financial changes and refiling of those claims to the appropriate payer source.
Responsible for the processing of all vendor claim updates, returns and resubmissions for payment. Other duties as assigned.

Employment Type