Revenue Cycle Operations Specialist

4 weeks ago

Cincinnati, Ohio, United States Purpose Home Health Full time
Job Description

We are seeking a highly skilled and detail-oriented Revenue Cycle Analyst to join our team at Purpose Home Health. As a key member of our revenue cycle operations team, you will play a critical role in enhancing our company's revenue cycle operations by developing and implementing strategies to increase revenue in a cost-effective manner.

Key Responsibilities
  • Maintain all Account Receivable functions in the Revenue Cycle Department, ensuring timely and accurate processing of payments, adjustments, denials, charges, demographics, claims, refunds, and write-offs.
  • Closely monitor and close the books weekly for all business units for Payroll and Billing purposes, ensuring compliance with accounting practices and regulatory requirements.
  • Process data in Continulink Software for all daily transactions, including posting payments, adjustments, denials, charges, demographics, claims, refunds, and write-offs.
  • Submit monthly invoices to Medicaid Spenddown Clients and negotiate payment arrangements for collections, utilizing Converge Software to process payments over the phone.
  • Edit and correct all denied claims to Indiana Medicaid through Web Interchange Software, ensuring timely resolution and minimizing revenue loss.
  • Billing all Traditional Medicaid and other Medicaid-Managed Health Care Services, such as Anthem, through Availity Software, Care Source, and MHS Software on a weekly or monthly basis.
  • Billing Veteran Administration clients weekly through VACCN software and receiving all payments through Optum Payment Service Software for all payment and denial status.
  • Prepare reports to work the Aging to decrease Account Receivable days and meet deadlines, ensuring timely and accurate financial reporting.
  • Communicate effectively with Clients, Medicaid, Veteran Administration, Staff/Management, and Others, providing excellent customer service and support.
Qualifications
  • PREFERRED: Degree in Accounting, Finance, or a related field; and/or equivalent experience in the Healthcare industry.
  • Knowledge of Indiana Medicaid guidelines and regulations.
  • Good organizational and time management skills.
  • Proficient in Accounting, Microsoft Office, Data Analysis, and other software programs.
  • Good analytical and critical thinking abilities.

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