Revenue Cycle Specialist - Manning - Business Office

Salary: $17.57 - $26.35 per hour, depending on qualifications
Schedule: Monday through Friday


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 working 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. Performing the functions and requirements for this position follows standardized procedures and policies requiring minimal judgment in their execution and will always remain within the defined scope for the
position.

The Revenue Cycle Specialist works with intermittent supervision and review, and any work problems involving.
departures from standard policies, interpretations, or procedures are presented to the supervisor for resolution.

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, as well as accepted.
confidentiality 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.
◦ Managing the resubmission processing of claims.
◦ Responsible for communicating observed payment trends, non-payment and/or incorrect payments to the management team.
◦ Completes assigned projects in coordination with management.
• Embraces and supports a professional working environment based upon an understanding and respect.
for diversity and multi-culture in all its forms; demonstrates sensitivity, acknowledges varied beliefs,
attitudes, behaviors, and customs; and encourages communication and appreciation of all forms of
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