Senior Revenue Cycle Specialist (Hybrid), Day Shift, Ambulatory Revenue Cycle

About the role

Adventist HealthCare seeks to hire an experienced Senior Revenue Cycle Specialist for our Ambulatory department who will embrace our mission to extend God’s care through the ministry of physical, mental, and spiritual healing.

Responsibilities

• Verifies and corrects insurance information, charges, and coding issues for electronic claims and manual corporate billing.
• Ensures that all billing guidelines are followed per the payer billing requirements.
• Contact insurance companies regarding the status of appeals.
• Daily reconciliation and elimination of billing backlogs.
• Follow up on payment errors, low reimbursement, denials, etc.
• Review EOBs and initiate appeals as necessary.
• Demonstrates working knowledge of coding (CPT, HCPCS, ICD-10, etc) as it relates to billing.
• Responsible for taking and resolving patient billing calls and inquiries.
• Demonstrates an ability to troubleshoot, report to management, and/or initiate resolution of all issues that occur with regard to billing operations.
• Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement in a variety of areas, including but not limited to: coding, claim submission, insurance and self-pay collections, refunds, and write-off approvals.
• Routine Reporting of Key metrics includes: AR days, cash collections, denials, avoidable write-offs, refunds, charge lag, bad debt, etc.
• Coincides with accounting to ensure accurate and timely month-end financial reports.

Qualifications

• Ability to effectively problem-solve and manage processes.
• Ability to work independently and handle a multi-task environment.
• Ability to actively participate on a team, supporting other team members and offering assistance to others as needed.
• Strong customer service skills, both on the telephone and face-to-face contact.
• Strong organizational and interpersonal skills.
• Must have the ability to guard confidential information (HIPAA).
• Bachelor’s or Associate's degree in Finance, Business, Accounting, or equivalent experience, and 7 years of experience in this field.
• Certified medical coder a plus.
• Experience with Electronic Health Records Software.
• Experience with eClinicalWorks is desirable.
• Maintains a high volume of processing without compromising quality and accuracy.

Pay

$24.41 - $34.18

Schedule

Full-time, 40 hours/week, Day Shift - Hybrid Schedule