- Employ continuous improvement efforts to improve key performance metrics for the focused area within the revenue cycle
- Provide ongoing monitoring of standards by conducting audits of all revenue cycle processes, vendors, and technology. Performs timely reviews of patient accounts, vendor work products, and remittances for denials to determine root cause of issue and appropriateness of actions taken, and assists in corrective action plan development
- Must have excellent analytical and problem-solving skills with proficient computer skills, including Microsoft Office applications.
- Participate in vendor and department meetings as needed
- Assist in identifying changes to policies, procedures, and technology to improve efficiencies; analyze department needs and suggest ways to improve workflow.
- Must have excellent organizational skills and ability to prioritize and coordinate workload with high degree of proficiency and accuracy.
- Maintain open, consistent, and positive communication with other Revenue Cycle departments, clinics, and vendor partners.
- Other projects as assigned
The RCM Specialist will need understanding of all revenue cycle processes but will be assigned to one of the following focused areas: Financial Clearance, Central Business Office, Commercial/Gov’t/SP AR Follow-up, or WC/API AR Follow-up.
Minimum Education
Required:
- High School Diploma, GED, or suitable equivalent
- Associate / bachelor’s degree
Minimum Experience
Required:
- 3 years of healthcare experience in clinical or office setting
- 1 year of healthcare revenue cycle experience
- Claim, Denial, and/or process auditing experience
- Previous experience with offshore revenue cycle vendors
- 2+ years of healthcare revenue cycle experience
- Denial reduction project experience
Knowledge Skills and Abilities
- Proficient in Microsoft Office applications
- Strong attention to detail to ensure the accuracy of data with the patient account.
- Ability to prioritize and manage multiple tasks simultaneously.
- Excellent interpersonal and communication skills, both oral and written