Revenue Cycle Specialist

At MGA Homecare, we strive to provide inclusive and comprehensive healthcare services to our patients and their families. For over a decade, we have been offering Private Duty Nursing, Skilled Nursing Visits, Occupational Therapy, Physical Therapy, and Speech Therapy services in the home and community-based settings. In 2022, we expanded our services to include MGA Behavior Therapy, which offers Applied Behavior Analysis (ABA) and early behavior intervention for pediatric patients with autism spectrum disorder (ASD) and other developmental disabilities.

Our mission is to ensure that our patients and their families receive the highest quality of clinical care with compassion and integrity at the forefront of our services. We strive to provide individualized attention and support to every home, making the lives of our patients and their families easier. MGA Homecare is proud to serve the states of Arizona, Colorado, North Carolina, Tennessee, Texas, and Washington, and we are committed to being a resource for all patients and their families regardless of their background, ethnicity, or identity.

The Revenue Cycle Specialsit will be responsible for overseeing the timely collection of outstanding accounts receivables. The manager will work closely with the Billing team on claim adjudication, The position will require extensive interaction with state Medicaid and will report to the Corporate Vice President of Revenue Cycle Management.

Duties and Responsibilities:

Billing/Claims Processing:

• Assists Billing Specialist and authorizations Specialist in resolving the current month's rejected or unbilled claims
  • including denials research
  • corrected claim resubmission
  • secondary billing
• Produces and presents progress against performance measures
  • Billing Tracker
  • Denial Tracker
  • Monthly Adjustments reporting
• Will  support other billers/collectors as needed

Account Management:

• Accountable for timely collections of outstanding accounts.
• Communicate with facility staff to gather necessary supplemental information
• Utilizes payor portals, and payor provider relations lines to timely follow up on submitted, denied and resubmitted claims and appeals.
• Communicates with Billing Specialists and Authorizations Specialists to gather necessary information for resubmission of claims or processing to secondary/tertiary payers
• Review, correct, and resubmit claims for internal system-identified errors
• Prepares documentation for appeals
• Produces and presents progress against performance measures (Collection Tracker)
• Participates in monthly account reviews with the Vice President of RCM
• Participates in other focus reviews as needed
• Conducts analysis of all accounts to complete timely adjustments to AR/claims, analyzes revenue impact to the Income Statement from adjustments and reports findings to upper management.
• Assists with the preparation of state and/or government audit reports as required including quarterly credit balance for Medicaid

Facility Support:

• Ensures accurate and timely status of assigned accounts during monthly AR reviews.
• Communicate with the supervisor regarding trends and suggested solutions.
• Completes various administrative activities & performs other duties as assigned.

General Duties and Responsibilities:

• Responsible for collections of all accounts for the assigned state and payer groups.
• Performs weekly review of AR aging for all account balances and acts to meet expectations & KPIs
• Responsible for resolving escalated business issues.
• Adjust workload timing and request training to meet the business needs of the facilities served
• Supports and executes the mission, ethics, and goals of the company effectively.
  • Represents themselves in a positive and professional manner in the company and community.
  • Adheres to dress code with a clean and neat professional appearance.
  • Reports on time and as scheduled to complete work within the designated time.
  • Adhere to all company policies and procedures outlined in the Employee Handbook, Employee Agreement, or communicated from the executive team.

• Associate degree or equivalent experience required; Bachelor's Degree preferred.
• Minimum 2 years of applicable experience in a healthcare (Homecare preferred) billing and collections environment.
• Extensive experience with the Arizona Medicaid plan (DDD) 
• Understanding of healthcare business service functions, including billing and collections, including HCFA/UB04, in a Homecare environment preferred.
• Elevated level of customer service experience.
• Must be proficient in the use of a personal computer and Windows environment software with an intermediate level of keyboarding skills.
• Intermediate level of MS Office Products - Word and Excel.
• Must have strong interpersonal skills including verbal and written communications.

All your information will be kept confidential according to EEO guidelines.

#IND123

At MGA, we prioritize diversity, equity, and inclusion (DEI) in both our organization and the communities we serve. We understand that DEI is crucial to our success as a healthcare company, allowing us to provide personalized care tailored to each patient's unique needs and preferences. Our belief is that everyone, regardless of their background or identity, deserves access to high-quality healthcare services. We respect and value the experiences, perspectives, and identities of all individuals, striving to create an environment where everyone can thrive. We are dedicated to attracting, developing, and retaining a diverse workforce that reflects the communities we serve, without discrimination based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.