Revenue Cycle Specialist II
2 weeks ago
Position Purpose **MUST RESIDE IN COLORADO** The Revenue Cycle Specialist II works with different programs within RMHS and revenue cycle department in order to consistently submit claims to insurance payers and to ensure that they are paid as per contract terms. This position is also responsible for communication with internal and external customers and health service providers. Essential Duties Performs insurance verifications, prior authorizations and re-authorizations as required by funding source Responsible for submitting claims and ensuring follow up on outstanding claims Ensures information obtained is complete and accurate to request appropriate authorizations Collaborates with internal departments and external providers on utilization management of authorizations Acquires and shares knowledge of authorization requirements for all funding sources for behavioral health in the State of Colorado (commercial and waiver) Ensures all services have authorizations properly documented in all software applications necessary and communicated to all programs within RMHS Ensures up-to-date documentation in billing software Ensures compliance with all federal, state, local and internal policies and procedures Performs other duties as assigned with a comprehensive understanding of all functions on the entire revenue cycle Knowledge, Skills and Abilities Knowledge of healthcare billing and reimbursement strategies. Ability to effectively communicate both orally and in writing. Demonstrates the ability to plan and organize work, coordinate with others, use time productively and establish appropriate priorities. Provide excellent customer service to both internal and external customers. Attention to detail is a must for researching and interpretation. Ability to support HIPAA privacy rules and maintain strict confidentiality. Ability to function as a team player. Ability to adapt to change and be flexible. Essential Functions Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Actively communicate with customers and stakeholders. Works with customers, staff, stakeholders. Ability to meet/work with staff, stakeholders in a variety of settings. Attends staff, team and department meetings. Attends in-services, staffing and other meetings with supervisor’s approval. May be appointed to committees. Develops and maintains records, plans and reports. Lift and/or carry 20 lbs. Sit, stand, and walk for reasonable periods of time. Maintains prompt and regular attendance. Performs related work as assigned. Qualifications **MUST RESIDE IN COLORADO** 1-2 years of relevant experience in finance/healthcare, medical billing & reimbursement. Experience with State and Federal (Medicare, Medicaid) and private insurance billing systems. Proficiency in Microsoft products including Word and Excel. Preferred Qualifications Previous experience working with healthcare insurance, billing (therapy services, behavioral health, Medicaid HCBS Waiver, Early Intervention), medical coding, denial management, and insurance reimbursement. Experience with medical billing software. Excellent communication skills (written, verbal). Excellent customer service skills. Rocky Mountain Human Services is an Equal Opportunity Employer and is committed to racial, ethnic and cultural diversity and the goals of the Americans with Disabilities Act. Note: This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job. Employment Type: Full Time Salary: $20 - $22 Hourly Bonus/Commission: No
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