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Senior Healthcare Revenue Cycle Specialist
2 months ago
About Vitra Health:
Vitra Health is a dedicated Home Health Care and Adult Day Health organization focused on the care management of adults and seniors. As a rapidly expanding entity, our mission is to enhance access to high-quality home health care services. We measure our success by the quality of care we deliver to our clients, recognizing that they are cherished individuals in our community.
At Vitra Health, we play a crucial role in providing comprehensive support to caregivers who look after their loved ones at home. We acknowledge the financial and emotional hurdles caregivers often face, frequently without adequate support. By being part of our organization, you can contribute to addressing these challenges. If you possess a positive outlook and a passion for helping others, Vitra Health is the right place for you. Our top priority is the well-being, satisfaction, and success of our team.
Position Overview:
Title: Senior Revenue Cycle Analyst
Classification: Exempt
Reports to: Revenue Cycle Manager
Department: Finance
Job Responsibilities:
- Enhance revenue processes, ensuring efficiency and accuracy in the submission of a high volume of insurance claims across various payers.
- Support revenue operations through detailed analysis of claim denials.
- Evaluate denial trends on a daily, weekly, and monthly basis using denial reporting tools.
- Review system reports to identify patterns in denials/non-payments and provide actionable insights to Revenue Cycle Leadership.
- Maintain a comprehensive understanding of EDI claims, remittances, and payer billing policies.
- Ensure accurate billing for services rendered across different programs.
- Collaborate with relevant departments to guarantee billing precision.
- Manage the submission of claims to various insurance payers.
- Oversee the daily re-authorization process.
Key Functions:
- Submit claims to insurance payers efficiently.
- Engage with insurance payers to ensure proper processing of all claims.
- Follow up on denied claims with the appropriate insurance entities.
- Reconcile paid claims to verify accuracy.
- Resubmit claims that are delayed or denied as necessary.
- Address any billing-related issues as they arise.
- Review and manage the eligibility process, identifying areas for improvement.
- Collaborate with departments to collect data for accurate billing.
- Develop and refine billing procedures by analyzing current practices and suggesting enhancements.
- Respond to billing inquiries by researching and interpreting relevant data.
- Maintain documentation and reporting in compliance with regulatory standards.
- Enhance job knowledge through educational opportunities, professional publications, and networking.
- Submit re-authorization requests for services to multiple insurance companies.
- Exhibit the ability to manage and influence change while working independently.
- Demonstrate a willingness to embrace new challenges and innovative approaches.
- Promote a culture of customer service and commitment to quality care.
- Act as a brand ambassador for Vitra, reflecting our vision, mission, and values.
- Show genuine interest and compassion for the communities we serve, along with a commitment to diversity among clients and team members.
- Perform other duties as assigned.
Qualifications:
- Bachelor's degree preferred.
- 3-5 years of relevant billing experience required.
- Experience in home health care or related health care sectors preferred.
- Knowledge of applicable laws and best practices.
- Proficient in MS Office, with Excel skills; familiarity with Waystar is a plus.
- Experience in implementing new systems is preferred.
- Understanding of insurance guidelines for Medicaid's Adult Foster Care and Adult Day Health programs.
- Exceptional attention to detail and accuracy in billing processes.
- Strong analytical and problem-solving abilities, along with excellent communication skills.
- Proficient in electronic health record (EHR) systems and billing software.
