Clinical Revenue Specialist

4 weeks ago

omaha, United States Nebraska Methodist Health System Full time

Join Nebraska Methodist Health System as a Clinical Revenue Specialist: Optimize Revenue and Enhance Patient Care


Join Nebraska Methodist Health System as a Clinical Revenue Specialist and play a vital role in optimizing our financial performance. In this position, you will analyze and research payment denials related to coding discrepancies and payer policies, coordinating appeal opportunities when evaluation supports such action. Your expertise will help identify areas for revenue improvement, ensuring our operations run smoothly and efficiently. With a minimum of 5 years of experience in coding or edit review required, you’ll be joining a team that values collaboration and professional growth. Enjoy a supportive company culture and an array of employee benefits that prioritize your well-being and career development.


Job Duties & Responsibilities:

  • Conducts thorough analysis to ensure the accuracy of payment denials and reviews them to support corrections or appeals.
  • Identifies, analyzes, and researches root causes and trends of denials to assist in the development of edits, process changes, or retraining initiatives.
  • Monitors denial patterns using reports, spotting trends, and tracking root cause preventative measures.
  • Proactively collaborates with coding and patient accounts to educate staff and reduce future denials.
  • Communicates problematic variances, delays, and issues impacting reimbursement to management.
  • Performs analysis to ensure accurate information and coding are entered on claims.
  • Utilizes internal resources to obtain reporting for analyzing denial trends and validates reports and data for accuracy and completeness.
  • Coordinates with revenue cycle, coding, and compliance teams to provide excellent customer service in response to inquiries from other departments within the Health System.


Schedule:

  • Work Schedule: Mon - Fri; standard daytime schedule while training, and flexible schedule upon completion.


Location:

  • Methodist Corporate Office - 825 S 169th St. - Omaha, NE


Salary:

  • Starting at $22.00 an hour and may increase based on work history/experience.


Job Qualifications:

  • High School diploma or General Educational Development (G.E.D.) required.
  • Minimum of 5 years of experience in coding or performing edit review required.
  • Certified Professional Coder (CPC) certification from the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA) preferred.
  • Knowledge of payment denials and appeals related to clinical services/charges.


About Methodist:


Methodist Health System named by Forbes in 2024 as "Nebraska's Best Employer" and "Best Employer for New Graduates"


Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa, more than 30 clinic locations, a nursing and allied health college, and a medical supply distributorship and central laundry facility. From the day Methodist Hospital was chartered in 1891, service to our communities has been a top priority. Financial assistance, health education, outreach to our diverse communities and populations, and other community benefit activities have always been central to our mission.


Nebraska Methodist Health System is an Affirmative Action/Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by Federal, state or local law.

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