Revenue Cycle Solutions Specialist na None

Purpose

The Revenue Cycle Solutions Specialist supports the revenue cycle departments of Wilmington Health by applying technical expertise in both software application support and data analytics, becoming a subject matter expert with existing and new software applications, and developing KPI dashboards to measure the success of the use of the applications as well as other revenue cycle efforts.

Essential Duties and Responsibilities

Revenue Cycle Software Application Support

• Learn the key features of the software applications in use and in the applications being implemented.
• Apply those features to improve utilization throughout the clinic, fully leveraging the benefits of the application.
• Teach others to use the application as appropriate for their role.
• Work closely with Information Technology and Vendor Teams to support it.
• Maintain knowledge of system features, including version upgrades and functionality changes.
• Work with all applicable departments to implement and train on new features.
• Participate in efforts to identify different or new technologies to adapt to clinic needs.

Revenue Cycle Data Analytics

• Maintain clinic fee schedules, working with application support teams to load any changes into the practice management and electronic health record systems as appropriate.
• Analyze clinic fee schedules against negotiated payer fee schedules, preventing under billing.
• Maintain payer fee schedules, updating per Wilmington Health contracts and industry published updates, submitting changes to Information Technology teams load into the practice management and electronic health record systems as appropriate.
• Compile data for and create revenue cycle monthly management reports.
• Identify trends and abnormalities in revenue cycle data, running ad hoc reports to assist with root cause analysis.
• Build dashboards to display key performance indicators and metrics for both operational and executive audiences.

Other- Compliance, HIPAA and Security

Maintains confidentiality and protects sensitive data at all times.

Meets highest compliance standards for all Federal and State regulations, including but not limited to, HIPAA, HITECH, Privacy, False Claims Act, etc.

Adheres to and models core values as well as organizational and department-specific policies and procedures.

Other Duties:

Other duties as assigned.

Qualifications

Required: Bachelor’s degree in communication, business, or healthcare, or equivalent work experience; Strong communication skills, both written and oral; Ability to meet multiple deadlines; High attention to detail; Excellent customer service skills

ADA Physical Demands:

Rarely (Less than .5 hrs/day) Occasionally (0.6 – 2.5 hrs/day) Frequently (2.6 – 5.5 hrs/day) Continuously (5.6 – 8.0 hrs/day)

Revenue Cycle Solutions Specialist Competencies

General

1. Customer Service
2. Professionalism/Integrity/Responsibility
3. Teamwork/Process Focus
4. Dependability/Punctuality
5. Interpersonal Relationships/Communication
6. Judgment/Decision Making/Problem Solving
7. Quality/Quantity
8. Initiative
9. Safety/Housekeeping
10. Organizational Skills/Time Management

Department Specific 

1. Working knowledge of Excel and/or other data management tools
2. Working knowledge of payer fee schedules and requirements
3. Ability to work independently
4. Ability to successfully prioritize tasks
5. Ability to manage multiple deadlines and priorities
6. Strong customer service skills
7. Excellent communication skills