Revenue Cycle Specialist

Job Description
Stamford Health is a well-established, award winning Healthcare System with multiple locations in CT.
As a new Certified Great Place to Work organization, Stamford Health understands what it takes to attract talent in order to improve our workforce and support our mission, to that end we offer:

• Competitive salary
• Sign on bonuses for designated positions
• Comprehensive, low-cost health insurance plans available day one
• Wellness programs
• Paid Time Off accruals
• Tax deferred annuity and (403b) pension plan
• Tuition reimbursement
• Free on-site parking and train station shuttle
• Childcare partnership with Children's Learning Center

The Revenue Cycle Specialist- Denials is responsible for researching, resolving, and resubmitting denied claims; taking timely and routine action to collect unpaid claims; and interpreting various forms of explanations of benefits (EOBs) from insurance carriers
Responsibilities for Internal Candidates

• Understands and interprets insurance Explanations of Benefits (EOBs), knowing when and how to ensure that maximum payment has been received.
• Researches and resolves rejected, incorrectly paid, and denied claims within an established time frame.
• Researches and resolves unpaid accounts receivable and makes any corrections in medical group's practice management system necessary to ensure maximum reimbursement for all services rendered.
• Resubmits claim forms as appropriate.
• Professionally responds to all billing-related inquiries from patients, staff, and payers in a timely manner.
• Utilizes available resources to identify reasons for payment discrepancies.
• Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding.
• Accurately documents patient accounts of all actions taken.
• Communicates with clinic management and staff regarding insurance carrier contractual and regulatory requirements.
• Educates clinic management and staff regarding changes to insurance and regulatory requirements.
• Actively participates in practice management and payer meetings.
• Accurately documents patient accounts of all actions taken.
• Establishes and maintains a professional relationship with all SHMG staff in order to resolve problems and increase knowledge of account management.
• Maintains standards set by management.
• Apprises management of concerns as appropriate.
• Informs management, as appropriate, regarding backlogs and time available for additional tasks.
• As necessary, negotiates a work improvement plan with management to raise work quality and quantity to standards.
• Completes additional projects and duties as assigned.

Qualifications for Internal Candidates

• Associate's degree or medical billing certification preferred. CPC preferred.
• 3+ years of experience working in a multispecialty group practice, healthcare system with an ambulatory focus, or academic medical center.
• 3+ years of experience working with a medical office/hospital accounts receivable system.
• Extensive knowledge of insurance payer reimbursement, collection practices, and accounts receivable follow-up.
• Demonstrates overall knowledge of claims processing for various insurances, including private and governed.
• Comprehensive knowledge of ICD-10, CPT, and HCPCS coding.

*We are committed to building an inclusive workplace that values diversity and inclusion and reflects the diversity of the community and patients we serve.
About Us
About Stamford Health
Stamford Health is a non-profit independent health care system with more than 3,800 employees committed to caring for the community through a wide range of high-quality health and wellness services. Patients and their families receive expert, compassionate care through the system's 305-bed Stamford Hospital; Stamford Health Medical Group, with more than 40 offices in lower Fairfield County offering primary and specialty care; a growing number of ambulatory locations across the region; and support through the Stamford Hospital Foundation.
Stamford Health is known for its expert, person-centered care through its many recognitions and partnerships. U.S. News & World Report has recognized Stamford Hospital as a High-Performing Hospital. The Centers for Medicare and Medicaid Services (CMS) rated Stamford Hospital as a five-star hospital for Overall Quality and The Leapfrog Group awarded Stamford Hospital an "A" for patient safety. The American Nurses Credentialing Center has granted Stamford Hospital Magnet Status, which recognizes superior patient care with the highest level of safety, quality, and patient satisfaction. Stamford Health is Planetree Gold-Certified for Excellence in Person-Centered Care and is a Certified™ Great Place to Work.
Stamford Health is a major teaching affiliate of the Columbia University Vagelos College of Physicians and Surgeons and has recently expanded its relationship with Columbia to offer treatment and expertise from Columbia University Irving Medical Center's nationally recognized heart surgeons. Stamford Health and Hospital for Special Surgery (HSS) have created a premier center for specialty orthopedic care right in Stamford, Connecticut. Additionally, in 2020 Stamford Health's Carl & Dorothy Bennett Cancer Center entered into an expanded collaboration with Dana-Farber Brigham Cancer Center.
Dedicated to being the community's most trusted health care partner, Stamford Health puts patients first to build long-lasting relationships. For more information, visit StamfordHealth.org. Like us on Facebook and follow us on Twitter, Instagram, YouTube, and LinkedIn.