This job description is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

This position oversees the overall policies, objectives, and initiatives of an organization's revenue cycle activities to optimize the patient financial interaction along the care continuum. The Document Management Specialist is responsible for managing lockbox/fax/mail documents that include patient account related requests for insurance payers and patients, identifies and distributes documents to the appropriate department, assist with validating patient demographic information on all returned mail.

ESSENTIAL DUTIES

• Manages account follow-up for underpaid and overpaid claims that are obtained through the lockbox, escalating unresolved issues internally as needed to achieve resolution.

• Reconciles account balances to ensure accurate financial status and compliance with contractual terms.

• Resolves underpayments by engaging in daily communication with payers and negotiating payment discrepancies.

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Leads the identification of opportunities to optimize revenue collection through proper coding, encounter/claims submission, denials management, and payment reconciliation across the enterprise

• Identifies and analyzes trends in underpayments, overpayments, denials, and revenue opportunities to recommend process improvements.

• Contacts patients as requested through lockbox transition requests.

• Participates in the development of coding and billing strategies, evaluating processes related to Revenue Cycle and making recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid, Medicare, and specific 3rd Party Payors).

• Ensures thorough and accurate validation of account analysis before distribution, maintaining compliance with policies and procedures.

• Performs other duties as assigned.

SKILLS/QUALIFICATIONS/EXPERIENCE

•2+ years’ experience in medical document management.

•Must have high school or equivalent educational experience.

•Demonstrate an understanding of healthcare management, including staffing and leadership.

•Demonstrate an understanding of patient accounts.

•Ability to educate patients on explanation of benefits for insurance processed claims.

•Communicate effectively with healthcare workers, patients and insurance companies.

•Able to prioritize and organize tasks at hand.

•Strong attention to detail, positive attitude and a proven ability to lead a team to success.

•Proficient in Microsoft Word, Outlook and Excel.

•Knowledge of state regulations.

•Presentation skills are desirable.

•Must have excellent written and verbal communication skills.

•Able to work with a diverse group of people.

•Must be able to work in a fast-paced office environment.

•Associate degree highly preferred.

•5+ years of related experience required.

•Proficiency in Microsoft Office with advanced Excel skills.

•Experience with Intacct, ConnectWise, Ubersmith, System Integration and M&A a plus.

•Strong communication skills, written and verbal.

•Ability to work independently and manage time appropriately.