Senior Revenue Cycle Specialist

Join our dynamic Revenue Cycle team within the Yield Management Division as a Senior Revenue Cycle Specialist. Collaborate closely with other members of Yield to exceed department expectations.

As a Senior Revenue Cycle Specialist, you will lead critical functions ensuring departmental excellence. Your role involves resolving complex issues, analyzing discrepancies, and driving efficiency in payment processes across multiple platforms. Additionally, a Senior is a subject matter expertise and works directly with the Team Lead to ensure the success of the team in creating and identifying training materials and assisting with new hire onboarding and orientation, acting as a mentor for others on the team.

• A Senior Specialist is identified as a subject matter expert on all knowledge within the Revenue Cycle space.
• Collaborating with the Team Lead, you will develop and oversee onboarding materials to empower Specialists and Specialist 2’s with effective training.
• Completes or monitors organizational functions or processes, ensuring that they are completed accurately, on time, and in compliance with established policies and regulations.
• Maintains meticulous process tracking and generates detailed reports for management to ensure the highest quality standards in departmental actions.
• Analyzes, identifies, and implements procedural change opportunities to improve performance and efficiency, and maximize revenue or margins.
• Ability to resolve errors and handles exceptions of limited risk and complexity.
• Identifies opportunities to improve revenue cycle processes and proposes solutions to capitalize on opportunities. Works with manager to establish an implementation plan and can work independently or with support of Specialists to implement plan. Thinks critically through implementation of plans to identify gaps and make necessary adjustments.
• Serves as a key point of contact for other departments on the audit and the client. Resolves client and audit issues to completion with attention to detail and the highest level of professionalism.
• Posts payments to collection accounts, reconciles with posted bank transactions, works with AP department to have refund issued when needed, reconciles monthly bank statements with cash posting
  database. Posts adjustment transactions to collection system as well as client’s system.
• Access and understand necessary information from the various online systems, understanding the systems process in determining how a claim has been paid to accurately apply payments and adjustments and assists in determining the adjudication of funds. Has a detailed understanding of client systems and processes. Can serve as a subject matter expert on client processes.
• Prepares and records financial transactions for assigned accounts to accumulate and record accurate and timely financial history. Ensures monthly reporting for audit purposes. Prepares and records financial transactions for assigned accounts to accumulate and record accurate and timely financial history. Ensures daily deposit reconciliation; maintains daily, monthly reporting for audit purposes.
• Researches and accurately distributes payments with no apparent invoice number, or date-of-service. Researches and determines the correct claim for the payment if there is a valid patient/date of services and accurately applying payment to correct claim.
• Maintains thorough and detailed knowledge of compliance and recovery laws regarding processing and recoupment to ensure compliance with state laws regarding all cash processes as evident through the collection cycle.
• Maintains productivity goals and standards set by the department. Ensures all department rules and processes are followed. Alerts manager of system issues or other issues impacting productivity.
• Quickly grasps a working understanding of basic elements and concepts of audit operations. Demonstrates enthusiasm for learning and applying knowledge to the completion of tasks. Successfully integrates and executes new assignments with moderate guidance and direction.
• Showcases expertise in data analysis, problem-solving, and implementing innovative solutions to overcome job challenges. Makes well-reasoned decisions promptly, seeking guidance when needed.
• Demonstrates competency with tools of the job including but not limited to filing systems, computers, word processing & spreadsheet applications, web systems, Cotiviti and Client systems, data file structures and Power Point. Can efficiently download and format common file types.
• Demonstrates ability to plan, organize, and prioritize multiple tasks and ensure timely completion. Uses a structured and dependable approach to accomplishing assigned work.
• Shows initiative and a willingness to engage in all audit support activities. Reaches beyond current tasks to add value to broader team. Goes the extra step to solve problems instead of waiting for someone else to solve them.
• Demonstrates understanding of Cotiviti policies & procedures, and external regulatory requirements and performs duties in accordance with such regulatory requirements. Assures confidentiality and security of all data, adhering to all HIPAA laws and requirements. Demonstrates the skills, knowledge, and ability to ensure that our environment is a safe one, complying with industry standards.
• Works with clients, customers, and partners to accurately assess their needs, provide information or assistance, resolve problems, or satisfy requirements.
• Can be counted on to consistently meet or exceed goals and perform at expected levels of quality and productivity. Demonstrates willingness and readiness to take on more responsibility in support of the audit.

• 2 -4 years of related experience and/or Associate or bachelor’s degree preferred
• Preferred: Bachelor's Degree in Accounting, Finance, or Business, or five (5) years of relevant experience.
• Two (2) years financial and/or business-related experience.
• Proficiency in MS Excel required; Access strongly preferred.
• Demonstrates adaptability to work effectively both in a team environment and independently.
• Knowledge of revenue cycle practices.
• Healthcare experience a plus.
• Excellent organizational ability required to handle multiple priorities.
• Understands and embodies Cotiviti Core Values, Strategic Pillars, and Operations Disciplines to achieve successful performance in completing assigned responsibilities and interactions with the Organization both internally and externally.

Base compensation ranges from $22.50 to $24.00. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Date of posting: 5/10/2024
Applications are assessed on a rolling basis. We anticipate that the application window will close on 6/10/2024, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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