Revenue Cycle Specialist

POSITION SUMMARY: Under the direction of the Revenue Cycle Manager, the employee in this position is responsible for employee adjustments, private pay collections, customer service, posting charges, answering phones, billing and appeals. 

PRINCIPAL JOB DUTIES AND RESPONSIBLITIES:

1. Adhere to all policies of the organization, including (but not limited to) job description, certification/licensure requirements, mission statement, HIPAA, confidentiality standards and patient’s rights.  
2. Actively engage and stay up to date with organization’s communications and directives. 
3. Daily review of private pay accounts
4. Review statements prior to release
5. Ensures patient receives three statements
6. Reviews daily posting for accuracy
7. Updates job knowledge by participating in educational opportunities; reading professional publications; keeping current on Medicaid billing and reimbursement procedures.
8. Serves and protects the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements
9. Accomplishes billing department and hospital mission by completing related results as needed
10. Appeals claims as needed 
11. Bills assigned claims in Athena and or Cerner.
12. Reviews claims within Rev-Manager for appropriateness of claim.
13. Answers phone in professional manner
14. Maintains quality results by following standards.
15. Enhances billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
16. Utilizes collection agencies and small claims court to collect accounts by evaluating and selecting collection agencies; determining appropriateness of pursuing legal remedies; testifying for the hospital in court cases.
17. Collects delinquent accounts by establishing payment arrangements with patients; monitoring payments; following up with patients when payment lapses occur.
18. Maintain professional attire.
19. Maintain patient confidentiality at all times.
20. Wear identification badge while on duty.
21. Create detailed notes in the system to reflect all actions performed on account. 
22. Preforms assorted task as assigned by supervisor.
23. Assist with Daily deposit as needed.
24. Assist with Payment floor as needed. 
25. Set up payment arrangements. 
26. Scans EOB’s to Cerner as needed.
27. Works unpostables in Athena as needed. 
28. Assists with Medicare bad debt report as needed. 
29. Other duties as assigned. 

Equipment:

Computer and Printer Fax Machine

Copy Machine Telephone

Educational/Skills Required:

High school diploma required. Prefer experience in billing, excel and business environments. 

The employee in this position must possess excellent communication skills and organization skills to communicate with patients and staff. 

Experience:

Two to five years’ experience in Healthcare business office, billing and collections either hospital or Physician’s office. 

Responsibility for Confidential information:

This position could have access to patient confidential records and must comply with HIPAA regulations as well as Hospital Compliance Policies. 

Supervisory Experience:

This positon has no supervisory responsibilities. 

Working Conditions:

Primarily sitting, sometimes standing. Utilizes good hearing, vocal and visual skills. Occasionally requires walking about, bending and stretching. Equipment, boxes, materials, or supplies as lightweight (under 50lds) may require infrequent lifting, pushing or pulling. The incumbent works under good conditions in a clean environment.

The above statements reflect the general details considered necessary to describe the principal function of the job as identified, and shall not be considered as a detailed description of all work requirements that may be inherent to this positon. 

EEO STATEMENT:

Cleveland Area Hospital/Lake Area Medical Associates is an equal opportunity employer and considers all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and all other protected classes.