Revenue Cycle Operations Specialist

16 hours ago


Cincinnati, Ohio, United States Purpose Home Health Full time

Purpose Home Health Job Description

At Purpose Home Health, we are seeking a skilled and detail-oriented Revenue Cycle Analyst to enhance our company's revenue cycle operations. The ideal candidate will have a strong background in accounting and finance, with experience in developing and implementing strategies to increase revenue in a cost-effective manner.

Key Responsibilities

  • Maintain accurate and up-to-date account receivable records, ensuring timely payment from various payers, including Medicaid, Veteran Administration, and private insurances.
  • Closely monitor and analyze financial data to identify areas for improvement, implementing corrective actions to optimize revenue cycle efficiency.
  • Process daily transactions, including posting payments, adjustments, denials, charges, demographics, claims, refunds, and write-offs, utilizing Continulink software.
  • Prepare and submit monthly invoices to Medicaid Spenddown Clients and negotiate payment arrangements for collections, utilizing Converge Software.
  • Edit and correct denied claims to Indiana Medicaid through Web Interchange Software, ensuring timely reimbursement.
  • Billing Traditional Medicaid and other Medicaid-Managed Health Care Services, including 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 payment from payers.
  • Communicate effectively with clients, Medicaid, Veteran Administration, staff/management, and other stakeholders to resolve payment and billing issues.

The successful candidate will have a strong understanding of Indiana Medicaid guidelines and regulations, as well as excellent organizational and time management skills. Proficiency in accounting, Microsoft Office, data analysis, and other software programs is essential for this role.



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