Revenue Cycle Specialist na Open Cities Health Center, Inc.

OBJECTIVE/OVERVIEW 

Under the direct supervision of the Revenue Cycle Director, the Revenue Cycle Specialist performs professional-level duties, which generate and maximize earned income for Open Cities Health Center, Inc. These responsibilities include account resolution, denial management, soft self-pay collections, customer service, and coding oversight. This is a hybrid position with potential to be 100% remote.  

JOB RESPONSIBILITIES 

• Gathers, collects and clarifies patient information from OCHC service providers, referring physicians, clinics, and hospitals.
• Provides financial and benefits support via payer portals or direct phone calls
• Investigates rejected claims and makes corrections for resubmission.  
• Exercises independent judgment to resolve patient billing issues and to answer questions from patients, facility staff, and third-party vendors regarding patient accounts.  
• Researches and resolves credit balances
• Assists with audits, site reviews, and other regulatory requirements. 
• Follows HIPAA guidelines when accessing and sharing patient information.  Maintains patient and business confidentiality.
• Oversees data entry activities as it relates to revenue cycle management.
• Assists with provider credentialing for third-party payers.
• Reviews coding denials and provides payer details to be reviewed by certified coding specialist 
• Process Good Faith Estimates
• Other duties assigned as needed

KNOWLEDGE, SKILLS, AND ABILITIES 

• Ability to perform highly complex and varied tasks requiring a thorough understanding of the revenue cycle.
• Strong technical computer/technical skills
• Must have a thorough understanding of general accounting principles, medical insurance, coding, and associated regulations.
• Able to work independently with little supervision.
• Is highly accurate and with attention to detail.
• Demonstrates excellent problem-solving, communication, customer service, and decision-making skills with the ability to work under pressure, manage conflict, and appropriately prioritize responsibilities.
• Stellar verbal and written customer skills desired

MINIMUM QUALIFICATIONS 

• Two years of experience in a healthcare setting working in revenue cycle, patient accounts, and/or self-pay collections. 
• A high school diploma or above.
• Experience working in various software programs, including Microsoft Office, payer portals including MNITS

DESIRED QUALIFICATIONS  

• Certification as a Revenue Cycle Specialist (CRCS). 
• Experience working in eClinical Works (eCW)
• Experience working with patients and staff from diverse backgrounds, beliefs, and ethnicities.