Revenue Cycle Specialist

4 weeks ago

Orlando, United States Childrens Home Society of Florida Full time

Overview:
Children's Home Society of Florida: Ending the need for foster care as we know it from Children's Home Society Florida on Vimeo.

**Since opening our doors in 1902, CHS became a part of Florida's history.**

CHS has been committed to growing and evolving to provide the right services and solutions to address the needs of children and families throughout the changing times. Every day, our team works with parents and kids to empower them and encourage them. With innovative technology solutions and a dedicated, experienced team throughout the state, we’re changing the face of foster care and positively impacting children and families’ lives for generations to come.

**Join our team to continue to do good and create history serving Florida's children and families**

The Revenue Cycle Specialist, verifies and monitors client eligibility and processes accounts receivable collections for assigned behavioral health programs. Overall, the Revenue Cycle Specialist contributes to the CHS high performance culture by exhibiting our values and providing quality results that keep CHS as the premier provider of child, family and behavioral health support services.

WHY JOIN CHS?
- Uplifting mission-driven work **culture**:

- Make an impact in your community and become a part of Florida's **history**
- Growth and professional development opportunities
- ** Great benefits package**, including generous paid time off and holidays

**Primary Job Functions**

**1. Review and input client insurance benefits and eligibility.**
- Obtain prior authorization documents for submission to funders as assigned.
- Track and monitor prior authorization expirations.
- Input into electronic medical record system information regarding demographics, admissions, enrollments, insurance benefits, and prior authorizations.
- Perform eligibility, benefit assignment and authorization change updates and communicate changes to operations team members.
- Monitor claim submissions and denials for eligibility and authorizations errors; correct and resubmit as needed.

2. **Process accounts receivable collections.**
- Correct and resubmit unresolved or denied claims.
- Assist with writing and submitting appeals.
- Work closely and communicate effectively and efficiently with clinical staff to resolve billing issues.
- Review payer and clearing house files for errors and corrects as needed.
- Review and update client accounts and charges including insurance benefits, eligibility, authorization and demographic information.
- Research missing or incorrect claims data that may affect submissions or denials of claims.
- Follow up with insurance/payers as needed for resolution of claims.
- Reviews reports to identify outstanding balances by payer and/or client.
- Identify and researches trends to resolve recurring issues.
- Assist with credentialing and re-credentialing clinicians.

**3. Contribute to a positive, engaging work environment.**
- Develop a strong knowledge base and stay current on job-related issues and trends.
- Participate actively in departmental meetings, training and education, as well as the quality process.
- Comply with CHS’s code of conduct, policies, procedures and other obligations.
- Assist with training other team members and providing back up when necessary.
- Pick up projects on the fly; perform other duties as assigned from time to time.
- Demonstrate the CHS Common Bond values in the performance of all job duties.

YOU HAVE:
**Knowledge of**:

- Accounting practices and reporting related to billing and collections, including but not limited to accounts receivable, and aging.
- Billing and collection processes, payment posting
- CPT, ICD-10 insurance claim forms including electronic submission files

**Skills and proficiency in**:

- Planning, organization and time management
- Oral and written communication
- Interpersonal relationship building, collaboration and teamwork
- Computer systems and MS Office, including Word, Excel and Outlook

**Ability to**:

- Perform at a high level of autonomy, with general supervision.
- Perform under strong demands in fast-paced, diverse, sometimes ambiguous environments.
- Commit to providing high customer satisfaction with positive service delivery results.
- Meet critical deadlines, while maintaining attention to detail, accuracy and quality.
- Handle highly stressful, sensitive situations; maintain confidentiality and professional boundaries.
- Demonstrate the behaviors of our CHS Common Bond Values.
- Be energetic, passionate and adaptable with a deep commitment to social service, empathy for children and families and a positive approach to embracing and managing change

YOU NEED:

- High School Diploma or GED equivalent
- Two years of experience working in the health or behavioral health care industry processing claims, eligibility verifications and/or prior authorizations, required
- Experience with Electronic Health Record Systems

**-Preferred-**
- Bachelor’s degree

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