Facilities Revenue Cycle Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Review and manage facility claims throughout various phases of the revenue cycle promptly and in accordance with compliance standards.

• Monitor and evaluate outstanding facility accounts receivable for designated clients, proposing solutions to enhance client performance.

• Engage proactively with facility payers to pinpoint deficiencies and relay feedback to operational staff.

• Prepare, assess, and dispatch invoices to facility payers on a monthly basis or at designated intervals.

• Document and finalize special invoicing processes as mandated by facilities.

• Maintain facility contact directories to ensure open communication and responsiveness.

• Identify issues, determine root causes, and independently initiate and conclude timely resolutions.

• Collaborate and communicate with Claims Management Supervisors and Revenue Cycle Managers to prioritize tasks and optimize reimbursement.

• Employ a comprehensive analytical approach, critical and lean thinking, innovation, curiosity, and determination to enhance client performance.

• Stay updated on industry developments and regulatory changes.

• Cultivate and sustain internal and external relationships through exemplary customer service.

• Present analysis of client performance as instructed.

• Act as a backup for other team members as needed.

• Undertake additional assigned tasks.

• Maintain or exceed client performance metrics, including service level agreements, account review aging, monitoring incoming facility payments, and educating facility payers on consolidated billing.

⛳️ Requirements

• High School Diploma.

• A minimum of 1-2 years of experience in processing health insurance claims and/or denials or other healthcare accounts receivable experience, or familiarity with facility billing and consolidated billing guidelines.

• Strong ability to organize, prioritize, and manage multiple tasks effectively.

• Capability to learn, comprehend, and operate within specific compliance, client, and facility payer requirements.

• Approach all responsibilities, tasks, and interactions with a mindset geared toward continuous improvement.

• Proven understanding of relevant HIPAA regulations, Medicare, Medicaid, insurance, liability, and facility payment methods.

• Willingness and capability to adjust to changes in the work environment, procedures, priorities, and job responsibilities.

• Ability to thrive in both a cross-functional team environment and independently.

• Detail-oriented with a resourceful mindset.

• Self-motivated and proactive.

• Must possess strong critical thinking and analytical skills.

• Proficient in Microsoft Office applications.

• Candidates must be authorized to work in the United States, both now and in the future; this position does not provide current or future visa sponsorship.

🏝️ Benefits

• Discretionary bonus plan.

• Comprehensive benefits package.

• Retirement plan.

• Health coverage.

• Paid time off.

• Reasonable accommodations for qualified individuals with disabilities.