Revenue Cycle Management Aging Specialist

Major Duties

• Verifies patient eligibility and/or benefits via telephone or website, follows up with patient and health plan to determine coverage and documents findings in the ECR.
• Provides outstanding customer service to patients and staff via answering calls and emails to the billing office in a timely, accurate manner, and completes documentation in the ECR, if applicable.
• Affords support and training to lower-level staff.
• Assists patients in applying for and then approving them for a Sliding Scale or other available funding, notifies the patient, and enters the information into the ECR.
• Supports people in receiving services and families to access benefits, including Medicaid, and enrolls them in programs that may benefit them.
• Provides patients access to WA Apple Health BH Services Booklet.
• Accurately completes treatment cost estimate forms and payment agreements for patients and documents in the ECR.
• Responsible for running and maintaining daily account / follow-up reports over 90 days while maintaining organization’s productivity standards.
• Identifies potential trends in denials/reimbursement by payer or by type, denial reason, or coding issue and reports to supervisory staff for appropriate escalation.
• Maintains open and effective communication with payer provider representatives to assist in large scale denials/reimbursements.
• Reviews insurance remittance advices, researching denial reasons and resolves issues through well-written appeals; conducts follow-up process activities through phone calls, online processing, fax, and written correspondence.
• Works proactively to troubleshoot, demonstrates significant attention to detail, and applies analytical/critical thinking skills to analyze denials and reimbursement methodologies and brings timely resolution to issues that have a potential impact on revenues.
• Completes account audits as needed.
• Reviews self-pay claims to determine if a payer or funding can be entered, or confirms the claims are indeed self-pay.
• Reviews accounts for patient charges and prepares for statement processing.
• Runs statements and processes them for sending electronically.
• Contacts patients for payment requests, overdue payments, denied claims, and arranges payment plans.
• Responsible for identifying, researching, and resolving credit balances, missing payments, and unposted cash as it pertains to billing account follow-up.
• Responds to and submits refund requests.
• Reviews patient accounts for referral to Third-Party Collections, prepares the Third-Party Collections report, and submits account to Third-Party Collections.
• Communicates effectively with payer customer service representatives and maintains professional communication with team members to support denials resolution.
• Prioritizes tasks to meet multiple deadlines and productivity requirements.
• Completes training and attends weekly staff and other meetings.
• Completes the training for Apple Health/Medical insurance.

Guidelines

• Requires that the incumbent relies on specialized training and/or equivalent experience and performs duties in accordance with Washington Administrative Codes, Federal regulations governing the confidentiality of patient files, and Lifeline Connections Policy and Procedure Manual.

Personal Contacts

• Contacts are with the members of the treatment team, consumers, significant others of the consumers, representatives of various community agencies specializing in the treatment of chemical abuse and mental illness.

Physical Demands

• While performing the essential functions of the job, the employee is regularly required to sit, speak clearly, hear, and use hands and fingers to manipulate writing utensils and keys on a keyboard.

Working Environment

• Working hours are spent indoors in offices or other meeting rooms.
• Participation in staff retreats and staff development activities will be required.

Immediate Supervisor

• Revenue Cycle Manager

Salary

$18.84 - 20.65/hr DOE

Application Process

To apply electronically for this position, please click "Apply Now" or visit our ADP career center.

The Benefits

• Lifeline Connections strives to be an employer of choice by offering regular and full-time employees a robust and highly competitive benefits package designed to support both personal and family well-being.
• Our comprehensive benefits include multiple options for medical, dental, and vision coverage for employees and their eligible dependents.
• In addition, Lifeline Connections provides employer-paid Short Term Disability, Long Term Disability, and Life Insurance, along with access to supplemental coverage options.
• Full-time employees and eligible part-time employees may also enroll in our 401(k) retirement plan, helping support long-term financial wellness.
• Beyond benefits coverage, Lifeline Connections is proud to offer generous paid time off.
• Both full-time and part-time employees earn PTO at competitive accrual rates that increase with years of service, allowing for meaningful time away from work.
• Employees also receive paid holidays and personal holidays, reinforcing our commitment to work-life balance and employee well-being.