Revenue Cycle Specialist

Hunter Health; Wichita (KS); Remote; USD 42,000 - 56,000; Full time

Benefits offered by this job

PTO 20 days/year

10 paid holidays

Employer-paid life insurance

Short-term disability

Long-term disability

Employee Assistance Program with 12免费会

Medical

Dental

Vision

401k with Safe Harbor Plan match

Job summary

Hunter Health Clinic, Inc. in Wichita, KS is seeking a Revenue Cycle Specialist to manage insurance claims and patient accounts, ensuring accurate billing and timely payments.

You will review medical, dental, radiology and vision claims, post payments and denials, and communicate with payers and patients to resolve issues while adhering to federal and clinic policies.

Qualifications

• High school diploma or GED required.
• 1-3 years of medical and/or dental billing, health care administration, or related field preferred.
• Knowledge of Medicare, Medicaid, private payer, workers' compensation, and third-party liability rules for accurate billing; FQHC billing a plus.
• Current knowledge of ICD-9 coding; ICD-10, DSM, CPT codes knowledge helpful; medical billing/coding certification preferred.

Responsibilities

• Provides accurate and timely submissions of claims according to payer rules and guidelines.
• Posts payments, adjustments to patient pay accounts, in a timely and accurate manner.
• Prepares and mails paper claims.
• Assists with aging monthly claims review and processing.
• Communicates with patients, payers, attorneys, and program contacts regarding claims and billing concerns.
• Provides input to Revenue Cycle leadership on benchmarks and progress on billing goals.
• Manages clearinghouse, payer portal rejections, and return-to-payer claims.
• Handles rebills or resubmissions as necessary.
• Batches and posts payments/adjustments to patient accounts per guidelines.
• Reviews remittance advice and denials for accuracy.
• Assesses reports to ensure all open claims are billed and resolved.
• Builds relationships with third-party payers and providers.
• Attends training to stay updated on billing rules and regulations.

Skills

Communication

Organization

Multitasking

Time management

Attention to detail

Teamwork

Initiative

Customer service

Education

High school diploma or GED

Job description

REMOTE IN WICHITA, KS

Hunter Health provides all-encompassing care for the Wichita community, including medical, dental, behavioral, vision, laboratory, radiology and pharmacy services, all in one place. We pride ourselves in providing the support patients need to take control of their health and their whole wellbeing. Our Hunter Health team is at the heart of our operations. From the initial interaction with a new patient to empowering individuals with the knowledge to manage their health - it begins with each member of our staff. Regardless of role or responsibility, every team member is a valuable part of living our mission and upholding our positive work environment with our Standards of Culture.

We exist to improve the health and wellbeing ofeveryonein our community.

Schedule

Monday - Friday, 40 hour week

Full Time Benefits

20 days of PTO per year, plus 10 paid holidays.

Employer-paid Benefits include

• Basic life insurance
• Short-term disability
• Long term disability
• Employee Assistance Program with 12 free sessions per year

Optional Benefits include

• Medical
• Dental
• Vision
• Supplemental life insurance
• Accident and critical illness insurance
• Identity Theft Insurance
• 401k with Safe Harbor Plan match

Summary

The Revenue Cycle Specialist is responsible for working with insurance companies and patients to promote the growth of patient service revenue. The role involves reviewing medical, radiology, obstetrics, dental, and vision claims to ensure current and accurate patient account records and accounts receivable. The Revenue Cycle Specialist functions in accordance with established federal, state, and clinic standards, while complying with all federal grants and Hunter Health Clinic (HHC) policies and procedures.

Essential Functions

• Provides accurate and timely submissions of claims according to payer rules and guidelines.
• Posts payments, slides, and adjustments to patient pay accounts accurately.
• Prepares and mails paper claims in a timely manner.
• Assists with reviewing and processing aging monthly claims.
• Communicates with patients, payers, attorneys, and program contacts regarding claims, billing concerns, collections, or financial transactions.
• Provides input to the Director of Revenue Cycle on benchmarks and progress on billing goals.
• Manages and monitors clearinghouse, payer portal rejections, and return-to-payer claims.
• Handles any rebills or resubmissions of claims, as necessary.
• Batches and posts payments and adjustments to patient accounts according to payer and departmental guidelines.
• Reviews remittance advice and denials from third-party payers to ensure accuracy.
• Assess reports and ensures that all open claims have been resolved and billed accurately.
• Builds relationships with third-party payers, providers, and other representatives.
• Attends insurance training sessions and other meetings to stay abreast of current medical and dental billing rules and regulations.
• Travels when necessary to meet operational needs.
• Performs all other duties as assigned.

Qualifications

• High school diploma or GED is required.
• 1-3 years of experience in medical and/or dental billing, health care administration, or a related field is preferred.
• Knowledge of Medicare, Medicaid, private payer, workers' compensation, and third-party liability rules for accurate billing is required, with knowledge of FQHC billing a plus.
• Current working knowledge of ICD-9 coding is required, and ICD-10 and DSM coding knowledge, along with CPT (Level 1 HCPCS), Level 2 HCPCS, and ADA codes, is
• Medical billing and/or medical coding certification is preferred.

Skills

• Listens, identifies, and responds quickly and effectively to internal and external needs.
• Communicates effectively with all patients, providers and stakeholders.
• Displays organizational skills, abilities to multi-task, and uses time and resources effectively.
• Displays good judgment and decision-making skills.
• Effectively collaborates and seeks clarification and confirms accuracy as needed.
• Utilizes teamwork to achieve desired results and contributes to projects while developing positive working relationships.
• Pursues goals with commitment and takes initiative eagerly.
• Demonstrates accuracy, thoroughness, and reliability; manages time and priorities; develops and follows work procedures.
• Evaluates own performance and accepts constructive feedback to continue learning.

Physical and Mental Demands of the Job

All employees, including those who become disabled, must be able to perform the essential job function listed below, either unaided or with the assistance of a reasonable accommodation. The functions listed below are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position. This essential functions document does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

• Talking: The ability to speak clearly and effectively.
• Average Hearing: The ability to hear average conversations and respond accordingly.
• Repetitive Motion: The ability to sit, stand, walk and use hands to handle, feel and reach.
• Finger Dexterity: The ability to use fingers to make small movements such as typing, picking up objects and pinching fingers together.
• Average Visual Abilities: The ability to focus on items clearly, including close vision, color vision and the ability to adjust focus.
• Working Conditions: The ability to work in a well-lit, climate-controlled environment, with a noise level that is occasionally high. There is potential exposure to infectious diseases.
• Physical Strength: The ability to occasionally lift and/or move up to 10 pounds.
• Mathematical Ability: The ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. This is not an exhaustive list of all duties and responsibilities associated with this job. Hunter Health Clinic Inc. reserves the right to amend and change responsibilities to meet business and organizational needs.

To learn more about Hunter Health, our services and our impact on the community, visit our website at www.hunterhealth.org.

Hunter Health provides equal employment opportunities to persons without regard to race, religion, color, ancestry, genetic information, sex, pregnancy, marital status, national origin, age, disability or veteran status, and any other status protected by federal, state, or local laws. HHC is committed to taking affirmative action to employ, and advance in employment, disabled persons and veterans.

As an Urban Indian Health Program, Hunter Health Clinic, Inc. (HHC) adheres to the Indian Preference in Employment as stated in the Federal Acquisition Regulations System (48 C.F.R. § 326.501–505). Training and employment preferences and opportunities shall be provided to Native Americans regardless of age (subject to existing laws and regulations), sex, religion, or tribal affiliation. Applicants claiming Indian Preference may be asked to provide documentation of eligibility.

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