Revenue Cycle Specialist III
4 days ago
Tell me About this Role:
Under general supervision and following established practices, policies, and guidelines, provides payments indexing and posting to Patient Financial Services, performing duties which may include preparing, indexing, and posting payments, performing daily reconciliation, processing payment transfers, reviewing and submitting claims to payors, performing account follow-up activities, updating information on patient account. Position at this level requires advanced knowledge in specialized functions and a full understanding of the Revenue Cycle. Incumbents work independently and have a strong Customer Service, analytic and problem-solving skills, and can understand, interpret, and explain payor contracts and CSMC Billing and Collections Policy and Practices governing billing and collections and sound interpretation of same. Incumbents are expected to research, analyze and resolve complex cases and problem accounts with minimal assistance. Submits appeals and collect monies relative to physician reimbursement. Services as a technical resource (subject matter expert) to others. Incumbents may assist other team members. This position may be cross trained in other Revenue Cycle functions and provide back-up coverage. In this role you will demonstrate:
- Independent responses that are timely and accurately to all requests. Professional and courteous interaction with employees and internal and external customers. Basic knowledge of basic accounting principles and healthcare billing and collection practices.
- Detailed knowledge of medical terminology and coding (ICD, CPT, HCPCS, procedure, bill type, diagnosis and revenue codes).
- Detailed knowledge and understanding of regulatory and CSHS policies and procedures governing billing and collections.
- Effectively monitoring assigned work queues and workload, ensuring resolution of accounts in a timely and accurate manner.
- Adherence to documentation standards of the department and properly using activity codes.
- Accurately billing multispecialty claims within established timelines and initiating dialog with payors, patients and departments. Understanding of payor contracts.
- Successful completion of PRMPT 1.
- Ability to understand and analyze different bill types and their purpose and or billing process as needed.
- Ability to perform relevant mathematical calculations.
- Has computer competency including MS office, Web/Vs, Emdeon and CS-Link.
- Excellent verbal and written communication.
- Professional and courteous demeanor.
- Detail and problem-solving aptitude.
- Prioritizes, organizes work, and complete assignments in a timely and accurate manner.
- Typing 40 to 45 wpm (45 to 50 wpm preferred).
- Demonstrated ability to handle multiple tasks frequently and with short timelines, to prioritize and organize work, and to complete assignments in a timely, accurate manner.
- Ability to work and communicate well with others. Demonstrated customer service skills.
Qualifications
- High School Diploma or GED required. College level courses in Finance, Business or Health Insurance preferred.
- Minimum of 4 years of hospital Revenue Cycle experience required.
- Collection experience highly preferred.
Experience/Skills Sought:
English speech, spelling, grammar, and simple math skills equivalent to high school level required.
Ability to perform relevant mathematical calculations.
Must possess computer competency comprised of a detailed knowledge of MS office, Web Vs, Hospital Patient Financial Service Billing Application, i.e. Emdeon, Availity and CS-Link.
Detailed knowledge and understanding of regulatory and CSHS policies and procedure governing billing and collections.
Successful completion of PRMPT 1.
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