Revenue Cycle Specialist

4 weeks ago

Portage, United States NorthShore Health Centers Full time
Job DescriptionJob DescriptionJOB SUMMARY:
The Revenue Cycle Specialist provides leadership, direction, and support for delivering world class results while providing efficiency and effectiveness for the Revenue Cycle operations within the Revenue Cycle function of NorthShore Health Centers. This includes related activities specific to all billing, collections, secondary billing, A/R resolution and cash flow with respect to billing and the accurate presentation and maximization of the Revenue Cycle results.  These associates will work closely with all operational areas within NorthShore Health Centers and the NSHC revenue cycle function such as pre-service clearance, financial management reporting, patient satisfaction, Patient Access, coding and the payors to apply new and emerging approaches for the NorthShore Health Centers clinical, administrative, financial and operational areas. Further responsibilities include identifying, analyzing, and resolving all operational issues associated with the internal processing of accounts receivable while insuring annual cash flow.

The Revenue Cycle Specialist will actively look for opportunities to maximize revenue throughout the system to transform the patient experience with a focus on improving both the patient experience and satisfaction as well as providing accountability for strategic business units that impact the patient experience and service pillars of the organization. The incumbent will focus on opportunities to maximizing the patient experience and patient revenue by strategically re-engineering the revenue integrity processes to improve the patient experience, increase patient volumes and retain current patients by expanding the services in question.

The Revenue Cycle Specialist will exhibit behaviors consistent with the standards for organizational values of NorthShore Health Centers. Demonstrates actions consistent with NorthShore Health Centers “expectations” as duties are performed on a daily basis.

Scope of practice includes the following areas:
  • Billing and Collections
  • Revenue Leakage – (Denials, Missing Charges and Payment Variances)
  • Patient Service Call Center
  • Cash Application
  • Guarantor/Self-Pay Collections/Medicaid Eligibility
  • Payor Audits
  • Denial Resolution
  • Establish the parameter of the job in conjunction with NorthShore Health Centers senior management.
  • Independently identify issues, seeks solutions and acts to solve the various issues.  The incumbent will be proactive in problem remediation and act with the Manager and Directors knowledge or permission and inform management of actions at a later time.
  • Provides leadership and recommendation to revenue cycle leadership.
  • Responsible for the successful development and implementation of operating and capital budgets, goals, objectives, policies and procedures including monthly review, and analysis.
  • Providing updates and the necessary education, industry benchmarks and best practices to Revenue Cycle management including the respective operational leaders.
  • Provides feedback and updates on a regular and consistent basis concerning current operations. Demonstrates a strong orientation to working with fellow associates in a positive and participative manner, modeling behavior that is consistent with the organization’s mission and values.
  • Maintains confidentiality in matters specified by law and hospital policy, especially those relating to information about sensitive patient and/or financial data.
  • Interacts with patients/families, staff, and vendors with a variety of developmental and socio-cultural backgrounds.
  • Maintains professional relationships and convey relevant information to other staff within the facility and applicable agencies.
  • Works closely with other NorthShore Health Centers departments to insure the success of the patient experience and the maximization of patient revenue. 
  • Demonstrates positive interpersonal relations in dealing with physicians, patients, patient families, visitors, co-workers, executive staff, hospital volunteers, employers, insurance companies, legal community, legal counsel, and governmental entities.
  • Develops interdependent relationship with other NorthShore Health Centers departments and revenue cycle, as needed.
  • On-going involvement and required participation with respect to industry related groups and functions.
  • Develops in-conjunction with senior management an on-going personal development and succession plan.
  • Participates in the creation of a staff development to more fully develop and internal resources to fulfill long term objectives of the organization.
     
*These essential functions are a summary of the primary duties and responsibilities of the position, and are not intended to be a comprehensive listing of all duties and responsibilities.  The position will include other duties as assigned and duties are subject to change at management's discretion.
 

*This job description is not an all-inclusive list of functions and tasks. Over the length of employment these functions and tasks may change.

Diversity Statement
NorthShore Health Centers celebrates and supports the diversity of its workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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