Healthcare Revenue Cycle Specialist

2 weeks ago

Chamblee, Georgia, United States Skyland Trail Full time
Job Overview

Location
Adolescent Campus - Chamblee, GA

Education Requirement
High School/GED Equivalent

Job Category
Accounting and Finance

Position Summary

Healthcare Revenue Cycle Specialist

This role is integral to the daily operations of the Patient Accounts Department. The ideal candidate will demonstrate outstanding customer service when interacting with colleagues, the public, and external partners such as vendors and payers. The specialist will assist in resolving issues related to claim underpayments or denials and support team members throughout the process.
  • Manage payment posting, ensure timely billing, and follow up on all assigned accounts until they are settled or adjusted in accordance with established policies.
  • Examine account histories to accelerate payments and enhance cash flow.
  • Engage with payers as necessary to collect overdue accounts, handling a minimum of 45 claims or service dates daily.
  • Maintain effective communication with the director to report issues and provide updates on account statuses.
  • Assist in the preparation of documents, spreadsheets, or reports as required.
Key Responsibilities:
  • Ensure that claim batches and payment processing adhere to departmental guidelines, collaborating directly with the director and colleagues to meet established protocols and daily expectations.
  • Coordinate with accounting personnel on daily cash reconciliation tasks.
  • Participate in regular meetings with the team and director to address challenges, workflow concerns, and overall departmental matters.
  • Possess comprehensive knowledge of HIPAA standards and compliance, following appropriate reporting procedures.
  • Continuously monitor reports to ensure compliance with expected standards.
  • Assist with client statement inquiries as needed.
  • Initiate billing for assigned claims promptly through electronic formats, auditing claims to ensure all relevant information is captured, including authorizations and clinical documentation.
  • Maintain oversight of billed and pending claims to ensure full accountability for all assigned accounts.
  • Follow up on all unpaid claims over 30 days, analyzing aging reports to identify details of outstanding balances and documenting all collection activities.
  • Notify the director of any workload issues that may hinder timely follow-up on accounts.
  • Track unbilled claims weekly and inform the director of any trends or issues.
  • Review EOB/ERAs daily to identify denials or underpaid claims.
  • Collaborate with other departments on eligibility issues and necessary documentation to ensure timely collections.
  • Exhibit professionally assertive yet conscientious collection efforts.
  • Submit all account adjustments for director approval as appropriate.
  • Complete refund request documentation for director review within policy guidelines.
  • Resolve credit balance accounts on a monthly basis.
  • Perform additional duties as assigned by the director.
This position requires proficiency in the following areas:
  • Extensive knowledge of healthcare insurance billing practices.
  • Thorough understanding of payer-specific billing guidelines.
  • Proficiency in Excel, Word, and other relevant IT systems.
  • Strong medical terminology and coding knowledge.
  • Familiarity with HCFA and UB forms.
Benefits:
  • 9 paid organization-wide holidays
  • 1 paid personal holiday
  • Accrued PTO
  • Medical, dental, and vision insurance plans
  • Employer match toward 403(b) retirement savings account for eligible employees
  • Employee assistance program offering financial counseling, mental health support, and other confidential professional assistance
  • As a 501(c)(3) nonprofit organization, eligible employees may qualify for the federal student loan forgiveness program.
Workplace Culture:

Skyland Trail is a nonprofit organization focused on its mission, with multiple campuses and a dedicated team of employees. Collaboration is key, as employees work in small teams and participate in cross-departmental committees to ensure quality and performance improvement. Every employee plays a vital role in supporting clients' healing and recovery.

Skyland Trail values diversity and inclusion, striving to reflect these principles in all aspects of its operations.

Qualifications:
  • High School diploma or equivalent.
  • 5+ years of relevant experience in a high-volume healthcare environment with responsibilities in health insurance billing and accounts receivable.
  • Mental health billing experience is preferred.

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