Revenue Cycle Management Specialist

2 weeks ago

Olathe, United States KVC Health Systems Full time
Job DescriptionJob DescriptionKVC Health Systems is looking for energetic, positive, caring professionals to join our team. If you are looking for a rewarding career and a compassionate work environment – KVC is the place for you

KVC Health Systems, headquartered in the greater Kansas City area, is a private, nonprofit 501(c)3 organization and a national leader in child welfare and behavioral healthcare. The organization is committed to its mission of enriching and enhancing the lives of children and families by providing medical and behavioral healthcare, social services, and education.

We all need connection, and that is why we exist. By providing in-home family support, therapeutic services, foster care and adoption case management, substance abuse treatment and psychiatric care, KVC touches the lives of over 60,000 children and families each year.

KVC Health Systems is seeking an RCM Specialist who will be responsible for account receivables, billing, and payment and other departmental responsibilities as explained in the role below.

This is a hybrid position - 3 days in office and 2 days remote

Account Receivables Responsibilities:

  • Monitor accounts receivable reports daily to ensure claims are paid according to contracted rates
  • Identify and report irregular insurance payments.
  • Investigate and resolve credit balance accounts.
  • Ensure denials and rejections are worked in a timely manner.
  • Investigate refund requests and promptly take appropriate action.
  • Prepare and mail monthly client statements.
  • Investigate and resolve customers billing inquires.
  • Participate in cross training and provide backup coverage as needed.
  • Submission of appeals and or corrected claims as needed.
  • Stay current with payer policy changes.
  • Develop and maintain professional relationships with provider relation representatives.
  • Assist with financial aid applications and payment plans.
  • Coordinate with management to assist with month end projects and reporting.

Biller Responsibilities:

  • Perform a thorough account review to ensure accuracy and the submission of clean claims.
  • Submit professional and institutional 837 electronic billing files to clearinghouse.
  • Submit professional and institutional paper claims as necessary.
  • Prepare and send invoices for single case agreement claims.
  • Follow up on unpaid invoices.
  • Perform charge entry as needed.
  • Coordinate with various departments to clarify account information as needed.
  • Coordinate with management to assist with month end projects and reporting.

Payment Posting Responsibilities:

  • Download, scan, and file electronic and paper insurance remittance advice
  • Perform daily cash management duties including bank deposits and payment log updates.
  • Interpret and verify adjudication detail prior to posting.
  • Post and reconcile payments, adjustments, and transfers in the patient ledger.
  • Utilize system reporting to ensure batch posting balances.
  • Partner with payer contacts to assist with questions and requests.
  • Investigate refund requests and promptly take appropriate action.
  • Coordinate with management to assist with month end projects and reporting.

General RCM Department Responsibilities:

  • Maintain and develop relationships with internal and external partners.
  • Ability to adapt and adjust to changing responsibilities, expectations, and processes.
  • Attend training and staff meetings as assigned.
  • Possesses strong verbal and written communication skills.
  • Assist with internal and external audits, as needed.
  • Exhibit initiative and ownership
  • Identify and report trends.
  • Assist in the development and communication of standard operation procedures.
  • Exhibits strong organizational skills.
  • Maintains strictest confidentiality, adheres to all HIPAA guidelines and regulations.
  • Perform other related duties assigned by management.

Education:

High school diploma or equivalent

Licensure/Certification:

Valid driver’s license and auto insurance


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