Help Desk Consultant

About This Role

The primary role of the Revenue Cycle Specialist – Billing Support Help Desk (RCS-BSHD) is to provide the necessary review and analysis of billing, claims, and other general inquiries received through the Direct Bill Help Desk queue(s) and to research and share findings to achieve service level goals and business objectives across Revenue Cycle operations.  

Essential Functions: 

• Efficiently work help desk tickets deposited into Billing Support, Direct Bill, and Hold Claim queues by internal and external customers through various ticketing pathways.
• Serve as support staff for various internal departments and external vendors by developing positive relationships, collaborating, and working cross functionally to resolve ticketing issues. Review and respond to respective inquiries initiated by these entities.
• Utilize problem solving and critical thinking skills to support account/patient claim escalations, related grievances, billing/reimbursement/coding inquiries received from the sales team, accounts, and other internal and external customers.
• Maintain a positive, service-oriented attitude and working relationship with all customers, patients, and iRhythm associates
• Investigate and provision ticket status updates as requested from the sales team, accounts, and all applicable stakeholders
• Track and manage ticketing cases until the issue is resolved within defined SLA parameters.  
• Conduct outreach to vendor partners and/or insurance companies when necessary to investigate/confirm patient eligibility and benefits; including estimating out of pocket costs and researching claims denials and/or rejections.
• Professionally respond to internal and external inquiries and phone calls from insurance companies and patients, providing answers to questions and concerns about claims and/or billing statements. Review and respond to correspondence and requests for medical record copies and other pertinent information to the appropriate sources.
• Work collaboratively with vendor partners to facilitate and/or support insurance billing and collections processes to improve Conall.
• Work closely with internal Revenue Cycle Business Partners to support the tracking/trending of account grievances and behaviors.
• Assist with the onboarding and training new team members as needed.
• Support overall Revenue Cycle processes to achieve established targets and goals, including the completion of special/specific assigned projects and other duties/tasks as assigned. 

Qualifications and Skills

• High School Diploma or equivalent; post-secondary education a plus
• Minimum of 3 years of healthcare related experience in billing and reimbursement or medical billing certification.
• Salesforce experience desired
• Insurance eligibility and benefit verification experience required with knowledge of cardiology billing preferred.
• Knowledge of CMS 1500 and UB04 Billing Forms, EOBs, claims, coding, and charges is required.
• Knowledge of third party and/or insurance company’s operating procedures, regulations, and billing requirements, i.e. Commercial, Medicare, Medicaid, etc.
• Ability to read and understand the information provided on EOBs, remittance advices, and other insurance correspondence.
• Knowledge of medical terminology and ICD-10CPT codes is beneficial.
• Excellent verbal, written, and communication skills.
• Effective customer service skills with the ability to interact with both internal and external customers.
• Ability to prioritize work, handling daily and multiple tasks to completion within the time allotted, while working as part of a team within a demanding environment.
• Demonstrated commitment to helping people to resolve issues including those that require independent thinking and sound judgment skills not covered specifically in manuals or procedures.
• Demonstrated patience and professionalism in stressful situations. Experience in a multitasking role preferred
• Proficiency with Microsoft Office tools with a sharp technical aptitude.
• Proficiency with payor portals, i.e., Navinet, Availity, etc.
• Ability to work independently with minimal supervision.

What's In It For You

iRhythm GBS Philippines is committed to providing an exciting career path for every team member, with unlimited learning opportunities for you. Our key focus is to ensure a healthy and well-balanced work life, which is why we provide you with comprehensive health and life insurance benefits, with eligible dependent coverage. We offer a competitive compensation package and above industry standard paid leave benefits. 

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