Revenue Cycle Systems Specialist

2 weeks ago

Urbana, Illinois, United States Carle Health Full time


Position Overview:

The Revenue Cycle Systems Specialist role focuses on the implementation, enhancement, testing, and management of systems and modules associated with revenue cycle applications. This position acts as a bridge between vendors, IT staff, application analysts, management, and end users to address inquiries regarding system functionality and design. It evaluates user requirements and suggests modifications while documenting procedural changes. The specialist develops both standard and tailored application reports and undertakes all analytical tasks necessary for program development, ensuring thorough documentation, testing, and final analysis to optimize job and system performance. Additionally, the role involves conducting team and integrated testing for all billing system functionalities and their interfaces, serving as a resource for users in creating efficient processes or new features.

Qualifications:

Educational Background:
An Associate's Degree in Computer Science, Accounting/Finance, or Business is required. Employees initially placed prior to a specified date are exempt from this educational requirement for this position only.

Certification & Licensure:
Epic Systems application certification must be achieved within two months following an Epic training course. Furthermore, new version training (NVT) must remain current.

Experience:
A minimum of two (2) years of experience in healthcare finance/revenue cycle or computer programming is necessary.

Skills and Competencies:
The ability to collaborate effectively with individuals from diverse disciplines possessing varying levels of technical expertise. Strong verbal and written communication skills are essential. Attention to detail with the capability to manage multiple tasks/projects concurrently. Proficiency in Microsoft Office Suite applications is required.

Key Responsibilities:

  • Oversee the development, testing, and maintenance of Epic modules and applications pertinent to Revenue Cycle, the Claims Manager System, and other related systems, interfaces, and billing processes.
  • Exhibit comprehensive knowledge regarding the functionality of all modules within the billing systems.
  • Demonstrate a solid understanding of project planning and develop plans for smaller projects.
  • Conduct comparative analyses of system designs against user requirements identified within the revenue cycle domain.
  • Collaborate as a team member to maintain various system parameter tables, including reference tables (ICD codes, payor plans, provider, procedures, etc.), enhancement logs, and more.
  • Coordinate and participate in unit and integrated application testing.
  • Identify system requirements within core revenue cycle areas.
  • Act as the primary contact for systems end-users regarding issues related to information system performance across revenue cycle areas.
  • Share responsibility for ongoing support of revenue software applications.
  • Investigate, document, and facilitate resolutions to issues reported by end-users.
  • Develop and monitor metrics for process improvements identified in system solutions.
  • Create ad hoc reports and application report templates for various purposes.
  • Review, research, test, and facilitate system updates while managing user maintenance for multiple systems.
  • Assist in the development and testing of third-party systems related to billing charge files and master files.
  • Research and leverage third-party software to establish programming logic that enhances operational processes.
  • Maintain a general understanding of CPT, ICD codes, HCPCS, and HIPAA Transaction Code Sets.
  • Draft reference materials and assist in documentation for training courses to prepare staff for effective system utilization.
  • May develop and coordinate system training for end users.
  • Provide support for 24/7 environments and participate in on-call responsibilities, including early morning and evening hours to meet customer needs.
  • Adhere to and enforce Carle Foundation Administrative and Departmental policies and procedures.

Carle Health is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment based on race, color, sex, age, national origin, religion, sexual orientation, gender identity, veteran status, disability, or any other protected class. Carle Health participates in E-Verify and may provide information from each new employee's Form I-9 to confirm work authorization.

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