Revenue Cycle Specialist

3 weeks ago

Baltimore, United States Healthcare For the Homeless Inc Full time $47,388 - $59,235
Job DescriptionJob Description


Overview

Revenue cycle specialist is an account receivables and billing expert who will perform necessary tasks for revenue cycle management including but not limited to claims management, A/R and denials follow-up and resolution, payment posting and collections management, Payer enrollment/credentialing and privileges, Authorization management.

Key Role Responsibilities

  • Perform a variety of RCM functions such as charge and payment posting, obtaining and tracking authorizations, processing of electronic EDI claims and electronic Explanation of Benefits (EOBs), follow-up on outstanding or denied claims, receivable management tracking and reporting, credentialing and privileging
  • Responsible for accurate and timely insurance claims follow-up and accounts receivable resolution with payers including appeals and submission of corrected claims
  • Accountable for aged claims and special accounts receivable projects
  • Adhere to government regulations, payer contracts and insurance guidelines when performing insurance follow-up, resolving open accounts and appealing claims
  • Be a key contributor to the Revenue Cycle by identifying and reporting inefficiencies and opportunities that enhance revenue flow, decrease denials and minimize write-offs
  • Respects and adheres to rules and regulations regarding patient confidentiality, HIPAA, and handling PHI (Privileged Health Information)

Skills Requirements

  • Exceptional detail orientation, critical thinking, analytical and problem-solving skills
  • Proficiency in government, commercial and/or insurance payer claims follow-up, denial resolution and appeals processes
  • Ability to interpret and apply insurance payer billing guidelines, claim rules and contract terms
  • Knowledge of CPT and ICD coding systems
  • Ability to collaborate and work cohesively as part of a team
  • Strong communication skills, both written and verbal
  • Excellent interpersonal and customer service skills to interact and maintain relationships with a wide range of personalities
  • Strong organizational skills necessary with strong accountability and drive
  • Demonstrated proficiency with databases and spreadsheets
  • Able to cope with interruptions, be flexible, and be a team player

Key Agency Responsibilities

In addition to role responsibilities, every staff member has the following responsibilities as a part of their employment:

  • Models and reinforces the core values of dignity, authenticity, hope, justice, passion and balance
  • Actively participates in performance improvement and advocacy activities that support the mission
  • Protects clients’ personal health information by maintaining compliance with HIPAA and other relevant health care-related IT security regulations
  • Performs other duties on an as-needed basis

Knowledge, Experience, and Skills

Formal Education and Training

  • Associate’s degree or equivalent experience
  • Certified Professional Coder (CPC) certification preferred

Experience

  • Two years or more revenue cycle experience in a health care setting required
  • Experience in and knowledge of Medicare/Medicaid/Commercial payer guidelines
  • Experience with Athena Practice Management would be a plus.
  • Familiarity with insurance verifications and prior authorizations is preferred
  • Experience working in a federally qualified health clinic (FQHC) is highly desirable
  • Comfortable working with homeless and/or low-income individuals and families



Health Care for the Homeless is an equal opportunity employer and is committed to racial equity and inclusion. We make a particular effort to recruit and promote Black, Indigenous and People of Color (BIPOC) for open positions. BIPOC, LGBTQIA+ individuals, people with disabilities, and people with other marginalized identities are encouraged to apply.

This is a "flexible" position: At least 50% of position will be remote. General telework location must be within reasonable driving distance of our Baltimore-based offices



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