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Revenue Cycle Specialist III-Government and Commercial Credits
3 months ago
What you will be doing in this role:
Under general supervision and following established practices, policies, and guidelines of Revenue Cycle Management supporting Professional Fee billing and collections. Duties include but not limited to, reviewing claims to payors, updating information on patient account, reviewing and processing credits, posting payments, and account reconciliations. Positions at this level require expert knowledge, skill and proficiency in CS-Link functions and multi-specialty areas of the revenue cycle. Incumbents have expert knowledge and understanding of regulatory requirements, payor contracts and CSHS policies governing billing and collections and sound interpretation of same. Incumbents are expected to research, analyze and resolve complex cases and problem accounts with minimal assistance. Serves as a technical resource (subject matter expert) to others and may act in the absence of the lead and/or supervisor. This position may be cross-trained in other revenue cycle functions and provide back-up coverage. Primary duties:
Independently responds timely and accurately to all requests. Interacts professionally and courteously with employees and internal and external customers.
Adheres to instructions, verbal and written, to achieve desired results. Assists supervisors in composing policy and procedure manuals and statements for the department. Communication is clear and easy to understand. Thoughts are coherent and logical.
Effectively manages time, maintains a clean and orderly workstation. Prioritizes work activities consistent with department goals and can balance daily workload and several projects.
Exemplifies high standards of professionalism, responsibility, accountability, and ethical behavior.
Applies detailed knowledge of and complies with all hospital, physician, and department policies, procedures (e.g., PHI)
Demonstrates detailed knowledge of CS- Link and/or department-specific systems and uses them effectively.
Effectively monitors assigned work queues and workload, ensuring resolve of accounts in a timely and accurate manner.
Adheres to documentation standards of the department and properly uses activity codes.
Accurately bills multispecialty claims within established timelines and initiates dialog with payors, patients, and departments.
Qualifications
High school diploma or GED required. College-level courses in finance, business, or health insurance preferred.
A minimum of 4 years revenue cycle experience to include professional revenue cycle billing experience required.
A minimum of 4 years of experience with Government Credits and/or Commercial Credits highly preferred.
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