RCM - Billing Specialist

ADP, Inc.; Scottsdale (AZ); On-site; USD 70,000 - 110,000; Full time

Job summary

Automatic Data Processing, Inc. in Scottsdale, AZ is seeking a Billing Operations Lead responsible for managing the end-to-end billing process and serving as the liaison between Flight Coordination and reimbursement activities.

The role focuses on maximizing reimbursement, accuracy, and timely payment through QA of revenue cycle processes. The ideal candidate has 5–7 years in healthcare billing or reimbursement, strong analytical skills, and experience with Salesforce.

Qualifications

• Education: High school diploma or GED, coding certified or higher.
• Experience: 5–7 years in healthcare billing/reimbursement or related field with analytics and project management.
• Knowledge of registration, billing, insurance follow-up, and commercial insurance analysis.
• Strong communication, analytical skills; ability to work independently and handle multiple tasks.
• Ability to manage staff and adhere to HR guidelines.

Responsibilities

• Develops revenue cycle and reimbursement reports; troubleshoots Salesforce reports.
• Analyzes workflow to improve reimbursement and ensures services are billed accurately.
• Monitors monthly A/R by payor and suggests corrective actions.
• Ensures payments are received and recorded at contracted rates; researches discrepancies.
• Provides feedback to leadership and trains staff on metrics.
• Drives revenue cycle meetings; creates action plans and follows up.

Skills

Project management

Data analytics

Salesforce

Communication

Independent work

Education

High school diploma or GED

Coding certification or higher education

Tools

Salesforce Workbench

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

CLAIMS Regular Full-Time Scottsdale, AZ, US

3 days ago Requisition ID: 1036

Summary

The primary purpose of this position is to manage the billing process and liaison by communicating and resolving root cause analysis (RCA) between Flight Coordination and follow-up to ensure maximum reimbursement to MHP. Acts as a focal point within the company for all revenue cycle activities, Quality Assurance, and Billing.

Relationships

Interfaces To: All employees, vendors and customers

• Develops reoccurring reimbursement/revenue cycle reports for revenue cycle. Troubleshoots Salesforce Workbench reports and trains staff on how to effectively report. Reports include target vs. actual collection rates and actual vs. target A/R days.
• Analyzes workflow and operational procedures to identify opportunities for improved reimbursement, develops and implements policies and procedures to ensure all services are captured, recorded, processed and billed in an accurate and timely manner.
• Analyzes monthly A/R reports by payor and monitors overall department performance. Recommends corrective follow-up actions and changes in procedures and/or negotiations with payors.
• Ensures payment is received, credited and recorded at contracted rates. Identifies and researches discrepancies and provides feedback to leadership.
• Analyzes billing and accounts receivable reports. Identifies payor trends, categories of aged receivables and provides action plans to departments to improve results. Works with payors and follow-up personnel to train on revenue cycle metrics.
• Works with Legal to ensure proper payment is received.
• Analyzes reports on reimbursement and collections to identify opportunities for improved coding and billing. Makes recommendations for new procedures to appropriate management staff.
• Monitors insurance cash collections policies and procedures and educates Flight Coordination staff to ensure best practice sharing across company.
• Provides reports, feedback and analysis of on QA functions associated with reimbursement
• Meets regularly with revenue cycle leadership to address their reimbursement and data needs and recommends target areas for reimbursement analysis.
• Understands vendor revenue cycle contracts, tracks and trends vendor effectiveness and provides feedback to revenue cycle leadership.
• Presents reimbursement findings to senior leadership highlighting action plans and areas of opportunity.
• Drives various revenue cycle meeting agendas, creates action plans, and follows up on department meetings
• Directs reimbursement staff projects, areas of opportunity and reporting focus with the help of Revenue Cycle Director

Workflow / Process Improvement

• Ensures Revenue cycle goals and productivity standards are met for optimum utilization

Qualifications

Required

• Education: High school diploma or GED, coding certified or a higher level of education.
• Experience: A minimum of five to seven years in a healthcare environment or work related experiences in the billing, auditing and reimbursement area work or related experiences and/or educational accomplishments with knowledge of project management, data analytics, Salesforce. A combination of both will be considered.
• Working knowledge of registration, billing, insurance follow-up and analysis of commercial insurance.
• Strong communication, analytical skills and the ability to work independently and handle multiple tasks is a must.
• Ability to manage staff and understand and adhere to human resource guidelines is required.

Preferred

• Experience: Process Improvement skills (Lean, Six Sigma, Process Excellence); Healthcare and revenue cycle experience (medical billing, collections); Experience reviewing 1500 claims; SalesForce.com experience. Knowledge of collections, reimbursement and Salesforce is highly preferred.