Revenue Cycle Operations Specialist II - 40hrs

Responsibilities

• Perform all Documentation Operations responsibilities, including receiving, sorting, scanning, indexing, and distributing incoming and outgoing mail.
• Ensure accuracy, timeliness, and quality of document processing within the document management system (OnBase).
• Process return mail, update guarantor status in Epic, and utilize available tools (e.g., Experian responses) to resolve accounts.
• Prepare and distribute outbound payor correspondence to support claims processing, reimbursement, and appeals.
• Identify and resolve issues related to document workflows and escalate as appropriate.
• Maintain department supplies and support administrative functions as needed.
• Perform all Credit Balances responsibilities, including identifying patient overpayments and processing refunds and redistributions in accordance with policies and procedures.
• Review and analyze account histories to validate credit balances and ensure accurate resolution.
• Prioritize and resolve escalated or complex refund and redistribution requests.
• Reconcile refund activity, verify accuracy of transactions, and ensure proper documentation within the system.
• Identify trends or discrepancies and escalate issues as appropriate.
• Provide support in Cash Posting operations as needed to ensure all patient accounting balances are accurately received and posted.
• Assist with reconciliation of payments, adjustments, and transactions to maintain accuracy of patient accounts.
• Identify posting discrepancies and collaborate with team members to resolve issues in a timely manner.

Qualifications

• Education: High School Diploma or GED or equivalent.
• Experience: Minimum of 3 years of experience in Revenue Cycle Operations or related healthcare financial operations.
• Knowledge: Working knowledge of healthcare revenue cycle operations, including billing, claims, payments, and account resolution; understanding of medical terminology, diagnosis and procedure codes, and reimbursement processes; knowledge of document management systems, electronic health records (e.g., Epic), and revenue cycle workflows; familiarity with compliance standards, confidentiality requirements, and HIPAA regulations.
• Skills: Strong proficiency in Microsoft Office Suite (Word, Excel, Outlook); effective communication skills for collaborating with internal teams and external stakeholders; advanced organizational and time management skills with the ability to manage multiple priorities; analytical skills to review account data, identify discrepancies, and resolve issues efficiently; problem-solving skills with the ability to independently troubleshoot and escalate appropriately; ability to meet productivity and quality standards in a fast-paced environment.

Team and Operational Contributions

• Demonstrate increased independence in managing daily work, prioritizing tasks, and meeting productivity and quality standards.
• Serve as a resource to Level I team members for questions related to processes, workflows, and systems.
• Participate in cross-training across functional areas to support operational flexibility.
• Ensure compliance with departmental policies, regulatory requirements, and confidentiality standards.

About Us

Connecticut Children’s is the only health system in Connecticut that is 100% dedicated to children. Established on a legacy that spans more than 100 years, Connecticut Children’s offers personalized medical care in more than 30 pediatric specialties across Connecticut and in two other states. Our transformational growth establishes us as a destination for specialized medicine and enables us to reach more children in locations that are closer to home. Our breakthrough research, superior education and training, innovative community partnerships, and commitment to diversity, equity and inclusion provide a welcoming and inspiring environment for our patients, families and team members. At Connecticut Children’s, treating children isn’t just our job – it’s our passion. As a leading children’s health system experiencing steady growth, we’re excited to expand our team with exceptional team members who share our vision of transforming children’s health and well-being as one team.