Revenue Cycle Specialist

The Revenue Cycle Specialist is responsible for managing the financial aspects of the company’s revenue operations. They are tasked with ensuring that the organization receives timely and accurate payments for the services it provides to patients. A successful Revenue Cycle Specialist will have a strong understanding of medical billing and coding, as well as excellent communication and analytical skills. They should also be familiar with relevant software systems, insurances and have a strong attention to detail.

• Prepare bank deposits to be approved and submitted, ensuring accuracy of information

• Maintain organized electronic records of all receivables using Microsoft OneDrive, allowing for access by all members of Accounting team

• Record and process insurance and self-pay payments against both internal and external invoices

• Consult with Director of Accounting on questions related to accounting and documentation criteria and collaborate with third party billing vendor to ensure reimbursements

• Collaborate and coordinate with Patient Relation Specialists regarding front desk operations related to self-pay billing, collections activities and data collection

• Provide data used to generate billing and accounts reconciliation reports

• Identify outstanding accounts receivable, ascertain reasons and take steps to follow up for collection resulting in the increase of revenue and decrease of aging

• Review patient eligibility to ensure patients are active with health plans we participate with. If patients are under insured or lack insurance, they are followed up with, and maintained in SFS, Medicaid and all other appropriate grant programs for payment of services

• Strive to meet all key performance indicators to ensure that cash flow is maximized throughout the Revenue Cycle

• All other duties as assigned

• Promote and maintain a safe working environment

• Establish and maintain effective work relationships with co-workers and patients

• Maintains regular attendance, and attends department meetings and any mandated continuing education/training programs

• Comply with all pertinent regulatory and agency regulations and operating standards

• Establish a work environment that creates positive communication between supervisors and employees and assimilates new employees to the Health Center’s culture, values and mission

• Participate in activities as part of the team that may include meetings, trainings, and committees

• High school diploma required

• Associates degree in Accounting, Finance, Business Administration or related field, and 2 years of relevant experience preferred, or equivalent experience

• Proficient in Microsoft Office Suite (Excel, PowerPoint, Word, Outlook, SharePoint, Office 365)

• Working knowledge of Medicaid, Medicare, Managed Care, and Commercial insurance plans

• Demonstrates professional, appropriate, effective, and tactful communication skills, including written, verbal and non-verbal

• Demonstrate an in-depth knowledge of private and governmental insurance eligibility and verification, charge capture, CPT maintenance, coding, billing and collections, payment posting and self-pay

• Experience working with EMR’s across the Revenue Cycle discipline

• Maintain competency by engaging in various training and continuing education programs approved by the Director of Accounting

• Strong knowledge of clinical practice and Revenue Cycle management including third party reimbursement guidelines and procedures

• Excellent time management skills with proven ability to meet deadlines

• Strong analytical and problem-solving skills

• Ability to act with integrity, professionalism, and confidentiality

• Behavior supports the mission, core values and objectives of the organization

• Accepts and readily adapts to changing priorities, new ideas, strategies, procedures and methods

• Demonstrates and promotes respect toward coworkers and adapts behaviors to work effectively with varying people and situations

• Accumulates all relevant information prior to making job-related decisions

• Presents well-considered alternatives when making recommendations

• Makes decisions in a timely manner

• Complies with quality assurance, OSHA, infection control, safety and other policies set forth

• The physical demands described here are representative of those that be met by and employee successfully perform the essential functions of this job and include the ability to type and operate a personal computer with various software programs, effectively operate standard office equipment, bend, stoop, crouch, kneel, twist, balance, and work at a desk, lift and carry up to 25 pounds, and communicate (written and oral) in a clear and professional manner.

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising work-flow and efficiency.