Revenue Cycle Specialist - Manning - Business Office

El Rio; Tucson (AZ); On-site; USD 40,000 - 70,000; Full time

Job summary

Join a forward-thinking healthcare organization as a Revenue Cycle Specialist, where you will play a crucial role in managing billing processes and optimizing workflows. This position offers the chance to work in a collaborative environment, ensuring patient confidentiality and compliance with regulations while advocating for patients and resolving billing issues. With responsibilities ranging from administrative tasks to direct communication with third-party payers, you will contribute to the efficiency of the revenue cycle. If you have a passion for healthcare and a knack for detail-oriented work, this opportunity is perfect for you.

Qualifications

• 3 years experience in medical or dental account receivables or claims examination.
• High School Diploma or equivalent required.

Responsibilities

• Perform administrative and fiscal duties in support of Business Office operations.
• Maintain patient confidentiality and ensure compliance with HIPAA standards.
• Communicate effectively with patients and providers regarding billing concerns.

Skills

Customer Service

Attention to Detail

Communication Skills

Problem Solving

Bilingual (English/Spanish)

Education

High School Diploma or G.E.D.

Experience in medical or dental account receivables

Coding Certification (preferred)

Tools

EPIC Electronic Health Record (EHR)

Job description

Revenue Cycle Specialist - Manning - Business Office

Manning House I, 450 W. Paseo Redondo, Tucson, Arizona, United States of America Req #6315

Schedule: Monday - Friday 8:00am - 5:00pm

JOB PURPOSE: The Revenue Cycle Specialist as part of a team is responsible for performing at a specialist level administrative and fiscal duties, tasks, and assignments in support of the Business Office Department and its varied operations. The Revenue Cycle Specialist will assist in optimizing the department’s workflow and processes out of the EPIC Electronic Health Record (EHR) system and must be knowledgeable of the organization’s policies, procedures, and business operations. The Revenue Cycle Specialist works closely with management and other revenue cycle paraprofessionals completing recurring administrative revenue cycle duties and tasks, managing cash inflow activities for the organization, as well as supporting resolution of obstacles to billing.

The Revenue Cycle Specialist serves as a conduit to identify business partner issues such as disputes with customers and summarizes information so that issues can be resolved. Responding to requests for information, records, and supports the facilitation of billing services and functions, while interfacing with multiple systems, online resources, and software programs. The Revenue Cycle Specialist may work in either a medical receivable or a dental receivable assignment, at a location assigned by management.

Essential Job Functions:

• Performs administrative, technical, and fiscal duties, tasks, and assignments supporting Business Office operations within established periods; meeting established rates of performance for the quality and quantity of work for the position; demonstrating a level of quality, efficiency, and accuracy in the employee’s job performance that ensures the highest standards of excellence.
• Maintains at all times patient confidentiality by controlling the information being disclosed to authorized individuals ensuring compliance with all HIPAA and corporate compliance standards.
• Participates in meetings with third-party payers to resolve contractual discrepancies or payment issues when needed/requested.
• Responsible for creating and completing system tasks related to revenue cycle elements including, but not limited to evaluating accuracy of patient financial information, insurance eligibility, verifying covered services via online and direct communication with health plan representatives and managing appeals and claims follow-up.
• Responsible for communicating observed payment trends, non-payment and/or incorrect payments to the management team.
• Advocates and educates patients and providers regarding billing concerns and responsible for establishing patient payment plans.
• Under supervision, researches, reviews, interprets, and processes healthcare services and claims in order to support accurate patient account and payer balances, applying correct account adjustments based on current CPT, regulatory, and payer specific billing rules.
• Maintains accurate and current information on patient account and payer balances by posting third-party and patient payments, adjustment, or denials.
• Obtains and maintains accurate information on patient financial responsibility by verifying patient insurance coverage and eligibility; obtains proper medical releases as required.
• Supports the continual improvement of the revenue cycle by assisting management and other colleagues on projects; provides feedback on processes and newly implemented changes in order to achieve continued process improvement.
• Responsible for completing system tasks and processing related to revenue cycle elements, such as evaluating the accuracy of patient financial information and managing the resubmission processing of claims.
• Embraces and supports a professional working environment based upon an understanding and respect for diversity and multi-culture in all its forms.
• Demonstrates an exceptional level of customer service, answering and responding to all incoming calls, emails, and inquiries in a timely and effective manner.
• Communicates effectively through written, verbal, and interpersonal skills as applied when interacting with employees, internal/external clients or representatives, or patients.
• Ensures accurate information is maintained for patient accounts and payer balances by posting third party and patient payments, adjustments/denials, and reclassifying charges to correct payers.
• Demonstrates a higher level of attention to detail, ensuring that required and entered information is accurate and payer balances are included in patient accounts.
• Gains and maintains an understanding of International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) standards and requirements.
• Attends and participates in conferences, workshops, and other training opportunities related to receivables billing, coding, and corporate compliance standards.
• Maintains a clean, safe, and hygienic work environment in compliance with all Policies and Procedures.

Minimum Education and Experience:

• High School Diploma or General Education Diploma (G.E.D).
• Three (3) years’ experience working in a medical or dental account receivables or claims examination role in a healthcare environment.

If applicable, equivalent combination of education and experience may be considered, and must be directly related to the functions and responsibilities of the job.

Required Licenses, Certifications, and Registrations

• Level I fingerprint clearance card: current valid and in good standing or have applied for it within seven working days after beginning employment.
• Employees in this position are required to have reliable transportation that can meet any operational reassignments of the organization during the workday.

Preferred Education, Experience, Skills, Abilities:

• Five (5) years’ experience working in medical or dental account receivables or claims examination role in a healthcare environment.
• Coding certification preferred.
• Bilingual (English/Spanish) with the ability to speak, read and write in both languages.

Reasonable accommodations may be made to enable individuals with disabilities; known limitations related to pregnancy, childbirth, or related medical conditions; and for sincerely held religious beliefs, observances, and practices to perform the essential functions of the job.

El Rio Health does not discriminate based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, or other non-merit-based factors.

El Rio Health requires all employees to have a Level One Fingerprint Clearance card. A.R.S. 36.425.03.

All employees are strongly recommended to obtain COVID 19 and maintain vaccination status (i.e., as recommended by CDC and/or other public health agencies).

All employees are required to undergo drug testing prior to employment and will be subject to post-accident, reasonable suspicion, return to duty and follow up drug and alcohol testing in compliance with Federal and State regulations.

El Rio Health is a non-profit 501(c)(3) Federally Qualified Health Center (FQHC) and abides by all applicable federal Drug-Free Workplace standards.