Revenue Cycle Specialist I, II

Southcentral Foundation (SCF); Anchorage, Northern (AK, KY); Hybrid; USD 60,000 - 80,000; Full time

Job summary

Southcentral Foundation (SCF) is seeking a Revenue Cycle Specialist to manage complex day-to-day issues in revenue cycle, including recovery, QA, and appeals. The role emphasizes denial management expertise, payment processes, and payer coordination.

The position includes coaching and mentoring others within the department and requires deep familiarity with payer contracts and exclusions. Two levels exist, enabling progression with increased responsibility.

Qualifications

• Bachelor degree in accounting, healthcare administration, finance, or business, or equivalent combination of experience; or equivalent credential.
• Certifications in revenue cycle management or coding are preferred (CPRCM, CPC, NCICS, HFMA CRCR).
• Experience with denial management and appeals within revenue cycle.
• Ability to train and mentor colleagues in the department.
• Familiarity with payer contracts, coordination of benefits, and exclusions.

Responsibilities

• Manage the most complex day-to-day issues within revenue cycle, including revenue recovery, QA, and appeals.
• Serve as a subject matter expert in denial management and related processes.
• Provide training and mentorship to colleagues in the Revenue Cycle team.
• Resolve complex account issues requiring technical knowledge and critical thinking.

Skills

Denial management

Appeals

Payment processing

Coordination of benefits

Payer contracts

Critical thinking

Training & mentoring

Education

Bachelor degree in accounting/health care administration/finance/business

Certified Professional in Revenue Cycle Management (CPRCM)

Certified Professional Coding (CPC)

NCICS Certification

HFMA CRCR

Job description

The Southcentral Foundation (SCF) Revenue Cycle Specialist is responsible for managing the most complex day to day issues within revenue cycle. These tasks include revenue recovery, quality assurance, and appeals. The Revenue Cycle Specialist is considered a subject matter expert in denial management and appeals, payment processes, coordination of benefits, prioritization and sequencing of payers, contracts, and exclusions based on payer contracts. The Revenue Cycle Specialist can be relied upon to provide training and mentorship to others within the department. The Revenue Cycle Specialist can solve complex account issues, which require a high degree of technical knowledge and critical thinking.

This position has two (2) levels designed to provide progressively more responsible and independent work experiences. Progression between job levels is based on the demonstrated ability to successfully handle more progressively responsible assignments.

Qualifications:

SCF programs are established to serve a primary population comprised of Alaska Native people who are affiliated with Cook Inlet Region, Inc. (CIRI) and Alaska Native and American Indian people within SCF’s geographical service area. Employees should have a thorough understanding of the cultures and the needs of this population. Such knowledge is critical to ensure the achievement of SCF’s Vision of, “A Native Community that enjoys physical, mental, emotional and spiritual wellness” and SCF’s Mission of, “Working together with the Native Community to achieve wellness through health and related services”:

• Bachelor degree in accounting, health care administration, finance, business, OR Certified Professional in Revenue Cycle Management, Certified Professional Coding Certification or Nationally Certified Insurance & Coding Specialists (NCICS) Certification, or HFMA Certified Revenue Cycle Representative (CRCR) or related field, OR equivalent combination of experience and education; OR demonstrated proficiency working as a Revenue Cycle Technician at Southcentral Foundation.

Additional Qualifications for Revenue Cycle Specialist II:

• Two (2) additional years of revenue cycle experience; OR equivalent combination of experience and education; OR demonstrated proficiency working as a Revenue Cycle Specialist I at Southcentral Foundation.

Native Preference:

Under P.L. 93-638, as amended, the company pursues a policy of Native preference in hiring, contracting and training. SCF Human Resources must receive certification before applicants receive preference.

Employee Health Requirements:

Compliance with our Employee Health procedure is a condition of SCF employment. You are required to agree that you will comply with all job-related employee health screening and immunizations prior to your first day of employment. Jobs designated as a Health Care Personnel (HCP) position, requires that you have documentation that you have completed the following immunizations prior to your first day of employment: MMR (Measles, Mumps and Rubella, Varicella (Chicken Pox), Hepatitis B, Influenza, and T-dap (Tetanus - Diphtheria - Pertussis)

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.