Revenue Cycle Specialist

1 month ago

Oklahoma City, United States Cohesive Healthcare Management Full time
Job DescriptionJob DescriptionDescription:

SUMMARY:

The Revenue Cycle Specialist will partner with client representatives within Revenue Cycle and the Patient Financial Services team to manage day-to-day operations in financial and operational metrics to identify and capitalize upon opportunities for process, cost, and patient satisfaction improvement. This position also serves as a liaison for training and subject matter expert on utilizing revenue cycle technologies and being self-sufficient in guiding our client partners. Reporting directly to the Revenue Cycle Director, the primary goal is to ensure maximum revenue for our client partners. This position is primarily remote, with travel to and from client locations.


This is a remote position in the Oklahoma City area. The employee will be required to travel frequently.

Requirements:

RESPONSIBILITIES:

· Working with the clinic managers to ensure that accurate billing information is entered into the billing system.

· Working with Cohesive billing company and clinic managers with oversight of revenue cycle department in various duties, such as account management, communications with insurance providers, collections, cash posting, contract analysis, and billing.

· Assistance with managing patient complaints in respect of billing and collections.

· Assistance with planning and structuring the department revenue cycle workflows.

· Assist Clinic Managers with maintenance and upkeep of EHR.

· Assist Clinic Managers with maintenance and upkeep of fee schedules.

· Assist Clinic Managers with monthly statements and collections process and provide audit and maintenance oversight Collaborate with other departments to ensure departmental on policies and procedures are adhered to and to identify opportunities for improvement.

· Works closely with other departments to foster positive working relationships and continuity within workflow processes crossing over departments.

· Works with leadership to help develop, monitor and coordinate consistent workflows and procedures across all teams.

· Ability to anticipate areas of need based on overall observations and interactions with management, employees, physicians, patients, payors, vendors, and third parties and respond effectively.

· Determines trends in operational performance and identifies process improvement opportunities including but not limited to up-front collections, reduction in insurance unbilled and reduced percentage of error

· Assist with the execution, analysis, and optimization of client workflows and in working with off-shore teams

· Ability to define problems, collect data, establish facts and draw valid conclusions

· Ability to successfully manage numerous tasks simultaneously

· Coordinates with client management on initiatives related AR aging, denial management and self-pay and POS collections / patient experience improvement

· Provides support to Billing Managers at critical access hospitals

· Additional duties as assigned


QUALIFICATIONS:

· Bachelor’s degree in healthcare administration, Business, or a related field preferred.

· Proven experience in revenue cycle management within a healthcare setting.

· Knowledge of medical billing, coding, and insurance claim processes.

· Familiarity with healthcare regulations and compliance requirements.

· Strong analytical and problem-solving skills.

· Excellent communication and interpersonal skills.

· Proficiency in using billing and electronic health record (EHR) systems.

· Excel spreadsheets and Microsoft Office products.

· Enhanced communication and customer service skills.

· Interpersonal Skills – The ability to establish oneself as a peer and trusted partner for our client counterparts

· Change Management – The ability to help counterparts through difficult transitions to a new process, workflow, or situation

· Motivation/ Drive – Successful candidates will have a desire for continues learning. Self-starting and going beyond what is asked to take on new challenges and create innovative solutions.

· Tenacity/Grit – This role will require getting deep into details and performing very granular reviews and extensive process shadowing. While this work can be tedious, it is foundational to success.


PREFERRED QUALIFICATIONS:

· Detailed understanding of the entire revenue cycle process.

· General knowledge of Revenue and ICD coding language.

· 1-2 years of experience in a hospital or clinic setting.

· Detailed knowledge of system tools and functionality used to perform revenue cycle functions

· Knowledge of Medicaid and Medicare billing regulations.


PHYSICAL DEMANDS AND WORK ENVIRONMENT

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. While performing the duties of this position, the employee is regularly required to work inside a clean, well-lit, and well-ventilated laboratory. While performing the duties of this position, the incumbent is regularly required to talk or hear. The employee frequently is required to use hands or finger, handle, or feel objects, tools or controls. The employee is occasionally required to stand; walk; sit; reach with hands and arms; climb or balance; and stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move a minimum of 25 pounds. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision and the ability to adjust focus. The noise level in the work environment is usually moderate. The employee may be exposed to some hazards such as radiation, bodily fluids that may contain disease, and fumes from laboratory chemicals. The employee may be required to travel frequently.

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