Senior Specialist, Revenue Cycle Commercial

Denver Health and Hospital Authority; Denver (CO); On-site; USD 80,000 - 100,000; Full time

Job summary

Join a mission-driven organization as a Senior Specialist in Revenue Cycle, where your expertise in insurance billing and claims processing will make a significant impact. This role offers the opportunity to mentor junior staff while ensuring timely reimbursement for hospital services. You will engage with various stakeholders, resolve unpaid balances, and contribute to the financial health of the organization. With a commitment to community care and outstanding benefits, this position is perfect for those looking to advance their career in a supportive environment. Be part of a team that values respect, belonging, and accountability.

Benefits

Up to 27 paid days off per year

Immediate retirement plan employer contribution

Generous medical plans

Free RTD EcoPass

Onsite employee fitness center

Childcare discount programs

Education & development opportunities

Professional clinical advancement program

Public Service Loan Forgiveness eligibility

Student loan coaching assistance

Qualifications

• 4+ years of hospital/medical office experience with emphasis on claims and insurance follow-up.
• Intermediate knowledge of insurance billing and processing regulations.

Responsibilities

• Ensure timely payments from insurance and patients by managing accounts receivable.
• Train staff and develop training materials for department efficiency.

Skills

Insurance Billing

Claim Submission

Analytical Thinking

Communication Skills

Attention to Detail

Problem Solving

Education

High School Diploma or GED

Tools

Accounts Receivable Databases

Various Software Applications

Job description

We are recruiting for a motivated Senior Specialist Revenue Cycle Commercial to join our team!

We are here for lifes journey.

Where is your life journey taking you

Being the heartbeat of Denver means our heart reflects something bigger than ourselves something that connects us all :

Humanity in action Triumph in hardship Transformation in health.

Department

Billing and Collections

Job Summary

The Revenue Cycle Specialist Senior works under general supervision. This incumbent provides financial clerical and administrative services to ensure efficient timely and accurate reimbursement of all inpatient / outpatient hospital and physician claims submitted by Hospital and Physician Services. The incumbent corresponds with insurance companies patients guarantors providers attorneys and other partners to resolve unpaid balances in a timely manner. Delivers customer service billing followup cash application processes reconciliation of payer remittances denial management and appeal functions. Provides financial guidance on selfpay accounts. Investigates delinquent accounts for legal liability. This role requires exceptional knowledge of insurance rules payor specific guidelines regulatory requirements claim submission processing and collections. Individuals in this role must possess strong attention to detail and excellent communication skills both verbally and in writing. This position requires an individual that can correspond professionally and competently on escalated issues / concerns as well as higher level detailed situations. This role serves as a resource and mentor for junior members. Assists in leading and openly supporting management in projects training and organizational initiatives to achieve departmental and cash goals.

Essential Functions :

• Maintain detailed knowledge of revenue cycle functions and metrics. Work accounts receivables to ensure timely payments from insurance and / or patients. Initiates claims submissions performs review of accounts ensures work performed is accurate and complete. Documents contact with patients guarantors insurance companies and others using the appropriate methods. Identify trends conduct followup and perform root cause analysis on unpaid and underpaid accounts. (50%)
• Trains staff responds to inquiries and complex questions and collaborates with Supervisor to develop training material and standard of work for the department. Builds trusting relationships with internal and external departments / business partners by providing confident leadership and timely communication. (20%)
• Completes worklists and / or reports as assigned. Performs deepdive analysis of KPIs identify underlying drivers uncovers new insights and makes datadriven recommendations to stakeholders which results in improved business and performance. (15%)
• Utilizes various payer systems provider portals and internal applications. (10%)
• Reviews websites bulletins etc. to keep current knowledge of regulatory requirements. Relays updated information to key stakeholders regarding policy changes. (5%)

Education :

• High School Diploma or GED Required

Work Experience :

• 46 years Four years minimum of hospital / medical office experience with an emphasis on claim submission insurance follow up insurance denials and credit balances. Required

Licenses :

Knowledge Skills and Abilities :

• Intermediate knowledge of insurance billing insurance processing and practices payor rules and regulations related to claim processing and applicable insurance definitions.
• Must have strong written and verbal communication skills analytical thinking high level of computer accuracy and organization and problem solving skills.
• Ability to prioritize work activities with minimal supervision in an individual and team setting.
• Ability to utilize various software applications and information systems to perform work processes.
• Working knowledge of accounts receivable databases. Skill sets to include 10key by touch and typing a minimum of 35 words per minute (WPM).
• Attention to detail and ability to demonstrate professional work behavior.

Shift

Days (United States of America)

Work Type

Regular

23.97 $35.96 / hr

Outstanding benefits including up to 27 paid days off per year immediate retirement plan employer contribution up to 9.5% and generous medical plans

Free RTD EcoPass (public transportation)

Onsite employee fitness center and wellness classes

Childcare discount programs & exclusive perks on large brands travel and more

Education & development opportunities including career pathways and coaching

Professional clinical advancement program & shared governance

Public Service Loan Forgiveness (PSLF) eligible employer free student loan coaching and assistance navigating the PSLF program

National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

Our Values

Respect

Belonging

Accountability

Transparency

All job applicants for safetysensitive positions must pass a preemployment drug test once a conditional offer of employment has been made.

Denver Health is an integrated highquality academic health care system considered a model for the nation that includes a Level I Trauma Center a 555bed acute care medical center Denvers 911 emergency medical response system 10 family health centers 19 schoolbased health centers Rocky Mountain Poison & Drug Safety a Public Health Institute an HMO and The Denver Health Foundation.

As Colorados primary and essential safetynet institution Denver Health is a missiondriven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community focusing on hiring and purchasing locally as applicable serving as a pillar for community needs and caring for more than 185000 individuals and 67000 children a year.

Located near downtown Denver Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

Denver Health is an equal opportunity employer (EOE). We value the unique ideas talents and contributions reflective of the needs of our community.

Applicants will be considered until the position is filled.

Required Experience :

Senior IC

Key Skills

Business Development,Apprentice,Asset Management,ABAP,IT Strategy,Manufacturing

Employment Type : Full-Time

Experience : years

Vacancy : 1

Monthly Salary Salary : 23 - 35

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