Revenue Cycle Management Specialist

Job Description

Job Description

Why Friends For All:

For more than three decades, Friends For All (formerly Friends For Life) has been preventing the spread of HIV and helping those affected by HIV/AIDS live well. Our holistic, client-centered approach provides a variety of services coordinated through one centralized model. We strive to address the roots of need—including stigma and inequality—to improve health and wellness for everyone we serve. Our goal is to eliminate new transmissions of HIV in Memphis and the Mid-South and empower those living with HIV to become their healthiest, happiest selves.

What is in it for you:

• A commitment to work-life balance with: (up to 38 Days Off)

  1. 12 accrued vacation days per year
  2. 12 accrued sick days per year
  3. 14 paid holidays, including Your Birthday!
  4. Sick Bank allows employees to donate sick time to other employees with a serious health condition who have no remaining sick or vacation
  5. Flex Schedule may be available based on position after introductory period

• Employer-sponsored health, dental, and vision insurance with two PPO medical and Dental plans. Costs for employee per pay period (bi-weekly)

  1. BCBS PPO Plans
  • PPO Gold premium = $28.88
  • PPO Platinum premium = $56.15
  2. Dental Plans
  • PPO Low = $1.14
  • PPO High = $5.81

1. Vision premium = $1.41

• 401k program with up to 3% employer match starting immediately
• Employer-paid basic life insurance valued at $50,000
• Employer-paid Short-term disability
• Voluntary Life and AD&D, Long-term disability
• Flexible Spending Accounts for healthcare and dependent care
• Student Loan Forgiveness Programs
• Employee Assistance Program with in person counseling options

What you can expect:

The Revenue Cycle Management Specialist will be responsible for all aspects of the claim cycle. They will oversee all medical billing and coding functions in the electronic medical record (EMR) system as well as providing direct supervision for the Oral Health program. The position will be responsible for ensuring the accuracy of data submitted in the EMR for third party billing contractors and ensure that patient services are billed appropriately between medical insurance, drug price control program, and/ or grant funding services.

How you will make an impact:

• Review patient charts and documents to ensure accuracy of billing codes entered in Athena Collector for billing.
• Assist in the oversite and implementation of insurance credentialing for the practice and providers.
• Provide follow-up and updates on provider enrollment and credentialing.
• Ensure that all codes are current and active.
• Report missing or incomplete documentation for proper billing and reimbursement.
• Create, update, and maintain document lists, billing policies and procedures for medical service billing.
• Assist with tracking, auditing files and generating reports for all relevant supervised programs.
• Update and/or create standard operating procedures for supervised tasks.
• Create reporting/audit tool as assigned by direct supervisor.
• Create and update program contracts/agreements as required by the supervised program Standard Operating Procedures.
• Ensure proper billing and payment with contracted laboratory services.
• Serves as a liaison regarding insurance resolutions and coding questions.
• Ensures accuracy of co-pays, balances, and charge posting as well as ensure patient services are billed appropriately between medical insurance, drug price control program, and/or grant funding sources.
• Follows coding guidelines and legal requirements to ensure compliance with federal and state regulations.
• Act as liaison between Friends for All, Athena Collector, insurance companies, and third-party billing contractor to ensure claims are processed and paid in a timely manner.
• Assist with staff training for Athena and other medical billing software as needed.
• Troubleshoot/Answer Athena requests and/ or queries.
• Communicate with patients as needed.

ADDITIONAL DUTIES AND RESPONSIBILITIES:

• Other duties and responsibilities as assigned.

• Participate in weekly or biweekly coaching sessions with supervisor

SUPERVISORY RESPONSIBILITIES:n/a

What you will bring to Friends For All:

What you can bring to Friends For All to be successful:

• Associate Degree preferred; at minimum must have a high school diploma or GED equivalent.

• Experience in clinical record keeping, online file management, referral processing and database development.

• Billing experience for multiple specialties

• Good strategic/critical thinker, self-starter, goal-oriented

• Excellent verbal and written communications.

• Ability to operate with purpose, urgency, and accuracy in a fast-paced, deadline-driven environment -- with particular attention to detail and organization

• Strong relationship-builder both with team and clients (internal and external)

• Competence in Excel and other Microsoft applications as well as Adobe

• Regular and predictable attendance is necessary.

• Maintain confidential information and adhere to all Friends for All policies and procedures regarding Protected Health Information (PHI).

CERTIFICATES, LICENSES, REGISTRATIONS:

• Must have a valid State Driver’s License,
• Must provide proof of automobile insurance coverage to employer at all times and have an automobile to be used daily.
• Must maintain a medical coding certificate that meets state licensure requirements (Certified Professional Coder (CPC).

COMMENTS:

This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.

Work Environment:

MISSION DRIVEN:

We’re a mission driven organization made up of people committed to cultivating growth and learning. We believe in providing care for all our clients while providing a welcoming, balanced environment for all our employees. By joining our team, you are joining a group of community focused professionals who connect people with care.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

• Must be sensitive to the culturally and racially diverse nature of clients, patients, employees, and visitors.
• Must be able to interact with everyone in a friendly, helpful manner.

ADA SPECIFICATIONS:

Physical demands that must be met in order to successfully complete the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Requires ability to drive an automobile and mobile unit
• Requires ability to speak audibly and listen actively.
• Requires ability to use computers, telephones and other office equipment.
• Requires ability to sit for extended periods.
• May require occasional bending and lifting up to 25 pounds.
• May require periodic local travel.

OSHA CATEGORY:

This position performs tasks that may involve exposure to blood, body fluids, or tissues. Training will be provided per Standard Operating Procedure for your area of operation. All FFA employees are offered the opportunity to receive the Hepatitis B vaccination series.

Equal Opportunity Statement:

Friends For All (FFA) is an Equal Opportunity Employer and Prohibits Discrimination and Harassment of Any Kind. FFA is committed to the principle of equal employment opportunity for all employees and to providing employees with an equitable and inclusive work environment free of discrimination and harassment. All employment decisions at FFA are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity, gender expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by all applicable federal, state and local laws or regulations. FFA will not tolerate discrimination or harassment based on any of these characteristics.

M – Th 8:30am – 5:00pm
Fridays 8:30am-4:00pm