Biller / Revenue Cycle Management Specialist
KPH Healthcare ServicesOhio, United States
Posted October 24, 2024
42000 - 43000 USD year
Full Time
About the Company
KPH Healthcare Services, Inc. is a national provider of pharmaceutical and healthcare services, offering a range of products and services across retail and commercial segments. The company comprises four divisions: Kinney Drugs with 98 full-service drug stores in New York and Vermont; HealthDirect Institutional Pharmacy Services for long-term care needs; ProAct, Inc., a pharmacy benefit management company with mail order pharmacy; and Noble Health Services, specializing in complex and chronic disease medications. KPH's diversified portfolio positions it as a comprehensive solution provider in the healthcare industry.
Job Description
The Revenue Cycle Management Specialist supports the company's billing function by ensuring accurate and timely payment collection from third parties. This role involves reporting misconduct, verifying coverage, preparing claims, and resolving billing issues. The specialist will also maintain accurate billing records and contribute to process improvement.
Requirements
- Report misconduct/unethical activities.
- Verify third party coverage and obtain authorizations.
- Prepare and submit claims for payment.
- Ensure compliance with laws and regulations.
- Review and approve refunds of overpayments.
- Maintain accurate billing records.
- Conduct surveys and participate in inspections.