Revenue Cycle Specialist I Professional Billing and Collec | Support Center | Days

About the Role

The Revenue Cycle Specialist I, under the direction of the Supervisor, performs all billing and collection activities for all inpatient, outpatient, emergency, and professional services provided by Onvida Health. This role combines responsibilities from various areas of Revenue Cycle operations, including third-party insurance billing and collections, payer denial review and appeals processing, payment applications, credit balance review and resolution, self-pay billing and collections, financial assistance, and bad debt applications. The position requires a background in hospital and/or professional accounts receivable and working knowledge of reimbursement requirements of healthcare payers.

Responsibilities

• Perform initial billing on third-party claims, either electronically or on paper, and review and correct all billable claims in billing software in accordance with payer-specific guidelines.
• Prepare and submit appropriate billing attachments as required by specific payors.
• Comply with all government and third-party payers' regulatory mandated requirements for billing and collections.
• Perform timely and appropriate follow-up on unpaid, underpaid, suspended, and denied accounts using system work queues, reports, and payer portals.
• Make outgoing calls to patients and insurance companies to obtain necessary information for accurate billing, collections, and correction of denials.
• Prepare appeal letters with appropriate supporting documentation for insurance carriers when not in agreement with claim denial.
• Review remittance advice to ensure correct payments for services rendered and resolve payment discrepancies.
• Review credit balance accounts and take appropriate action to resolve the credit balance.
• Handle self-pay accounts, including financial assistance and collection agency assignment, while providing exemplary customer service.
• Answer incoming patient phone calls and make outbound collection calls on open balances.
• Work with patients to set up appropriate payment plans and follow up on past-due payment plans.
• Identify patients with potential financial hardship and qualify them for Financial Assistance with all appropriate documentation.
• Handle bankruptcy and deceased accounts appropriately.
• Apply insurance payments, either electronically or from paper Explanation of Benefits (EOBs), and enter adjustments, denial codes, copays, deductibles, and co-insurance as indicated.
• Process transactions in the system, including handling patient cash, check, and credit card payments, daily balancing and reconciliation of cash collected, and preparing daily bank deposits.
• Manage cash clearing and PLB accounts, undistributed payments, credit balancing activities, and investigate unidentified accounts.
• Process refunds for patients and insurance companies.
• Organize work, prioritize individual and departmental workload, handle multiple tasks simultaneously, and meet deadlines.
• Maintain productivity and accuracy to meet monthly collection goals.
• Model core values consistently and contribute to team-building efforts within the department.
• Interact, communicate, and collaborate with team members to maximize group effectiveness.
• Mentor and assist in the training of fellow team members.
• Address issues and concerns directly with coworkers to promote mutual respect within the work unit.
• Contribute individually and through teams to the ongoing improvement of work processes.
• Perform other duties as assigned.

Requirements

• High School Diploma or Equivalent (required).
• 1+ year of experience in a healthcare setting.

Preferred Qualifications

• Working knowledge of self-pay or insurance billing and collections, and insurance terminology.
• Working knowledge of UB04, CMS 1500, and Explanation of Benefits (EOB) interpretation.
• Working knowledge of CPT, ICD-10, HCPCS, and modifiers.
• Working knowledge of medical reimbursement policies and procedures.
• Epic EHR experience.

Pay

The base hiring salary range for this position is $17.67 - $25.98 per hour, with actual salaries varying based on factors such as skills and experience. This range is just one component of the total rewards/compensation package offered.

Schedule

Regular full-time position, 80 hours every two weeks, day shift.

Location

Support Center

About Onvida Health

A career at Onvida Health is more than just a job. It’s a place to have a long and rewarding career, making a difference in the lives of those in our shared community. When you join our team, you become an integral part of a thriving community committed to improving the health and well-being of everyone in southwestern Arizona. At Onvida Health, we believe in progress with purpose. Our commitment to innovation is matched by our dedication to kindness and integrity. We take our values seriously because we know they lead to better outcomes for our patients and a better experience for all of us. We’re looking for people who approach each day with a sense of possibility, a drive to make things better, and a commitment to kindness.

About Yuma, Arizona

Yuma, recognized by Guinness World Records as the Sunniest City on Earth, offers more than just sunshine. It’s a place where the great outdoors meets a welcoming, tight-knit community. Hike scenic trails, explore the Colorado River, or immerse yourself in local cultural festivals – all while embracing the beauty of this desert oasis. With easy access to larger cities and popular destinations, Yuma makes it easy to balance a fulfilling career with time for personal adventures and relaxation.

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