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RCM Data Specialist
full-time•Guaynabo
About this role
The RCM Data Specialist will be responsible for working on the Avizzor portal, where they will audit and assign the billing of managed plans to the corresponding "Queques", as well as transmit cases in "Accepted" status.
Responsibilities:
- Check that each invoice has the supporting documents required by Avizzor. If any document is missing, locate it in CPR+ and attach it to the invoice.
- Validate that the total charges for each invoice are the same in CPR+ and Avizzor. Notify your Supervisor in case of discrepancy.
- Check that the service date is the same as the "Delivery Ticket" and that the prescription date matches the indexed one.
- Verify that the authorization number (PA) reported in Avizzor matches the attached authorization.
- Send all invoices that have "Accepted" status in Avizzor.
- Provide support and assistance in other tasks as necessary.
Required:
- High School Diploma.
- Certification as a medical plan biller. (Preferred) or equivalent to 2 years of experience in billing.
***EEOC F/M/D/V***
What you'll do
- The RCM Data Specialist will audit and assign billing for managed plans and transmit cases in 'Accepted' status. They will also ensure that invoices have the required supporting documents and validate discrepancies.
About Alivia Health
Guided by its tagline "patients first", Alivia Health is the strongest pharmacy network in Puerto Rico. Alivia Health currently supervises a portfolio of 5 healthcare enterprises that boast a collective workforce of over 700 highly skilled professionals.
Our brand promise stems from our H3C2 formula:
Humanity
We put ourselves in the shoes of others to serve our community with empathy.
Honesty
We communicate with sincerity and act with integrity in everything we do.
High Quality
We pay attention to details and exceed expectations.
Commitment
We give our all for the well being of our communities.
Collaboration
We work together to achieve a common purpose.
Learn more about Alivia Health’s portfolio:
Alivia Specialty Pharmacy is the leading supplier in Puerto Rico of specialty oncology products and other specialty medications.
Home Delivery is a closed-door pharmacy that provides services to home drug delivery programs.
Alivia Infusion Services offers a specialized service designed for patients recently discharged from the hospital, enabling them to seamlessly continue their infusion therapy in the comfort of their own homes.
Alivia Hub is the only pharmaceutical hub in Puerto Rico that implements patient management and compliance, as well as adherence programs for specialized drugs in collaboration with healthcare providers.
Farmacias Plaza was founded in 1962 and is Puerto Rico's largest independent retail pharmacy chain, comprising 14 retail store locations and 5 hospital-based outpatient express pharmacies.
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Frequently Asked Questions
What does a RCM Data Specialist do at Alivia Health?
As a RCM Data Specialist at Alivia Health, you will: the RCM Data Specialist will audit and assign billing for managed plans and transmit cases in 'Accepted' status. They will also ensure that invoices have the required supporting documents and validate discrepancies..
Is the RCM Data Specialist position at Alivia Health remote?
The RCM Data Specialist position at Alivia Health is based in Guaynabo, Puerto Rico, United States. Contact the company through Clera for specific work arrangement details.
How do I apply for the RCM Data Specialist position at Alivia Health?
You can apply for the RCM Data Specialist position at Alivia Healthdirectly through Clera. Click the "Apply Now" button above to start your application. Clera's AI-powered platform will help match your profile with this opportunity and guide you through the application process.