Revenue Cycle Specialist III

What You Will Be Doing in this Role:

Under general supervision and following established practices, policies, and guidelines of Revenue Cycle Management supporting Hospital, Professional Fee billing and collections. Duties include but are not limited to, reviewing and submitting claims to payors, performing account follow-up activities, updating information on patient account, reviewing and processing credits, posting payments, and account reconciliations. Positions at this level require expert knowledge, skill and proficiency in CS-Link functions and multi-specialty areas of the revenue cycle. Incumbents have expert knowledge and understanding of regulatory requirements, payor contracts and CSHS policies governing billing and collections and sound interpretation of same. Incumbents are expected to research, analyze and resolve complex cases and problem accounts with minimal assistance. Serves as a technical resource (subject matter expert) to others and may act in the absence of the lead and/or supervisor. This position may be cross-trained in other revenue cycle functions and provide back-up coverage. The Revenue Cycle Specialist III:

• Independently responds timely and accurately to all requests. Interacts professionally and courteously with employees and internal and external customers. 
• Adheres to instructions, verbal and written, to achieve desired results. Assists supervisors in composing policy and procedure manuals and statements for the department. Communication is clear and easy to understand. Thoughts are coherent and logical. 
• Effectively manages time, maintains a clean and orderly workstation. Prioritizes work activities consistent with department goals and can balance daily workload and several projects. 
• Exemplifies high standards of professionalism, responsibility, accountability and ethical behavior. 
• Applies detailed knowledge of and complies with all hospital, physician, and department policies, procedures (e.g., PHI) 
• Demonstrates detailed knowledge of CS- Link and/or department specific systems and utilizes them effectively. 
• Effectively monitors assigned work queues and workload, ensuring resolve of accounts in a timely and accurate manner. 
• Adheres to documentation standards of the department and effectively use activity codes. 
• Accurately bills multispecialty claims within established timelines and initiates dialog with payors, patients and departments. 
• May assume lead role in the absence of the supervisor, oversee day to day department activities and is able to effectively address any concerns that may arise. 

Requirements:

• High School Diploma or GED required. College level courses in Finance, Business or Health Insurance preferred.
• Minimum of 4 years of professional and/or hospital Revenue Cycle experience required.
• Experience with surgery highly preferred.
• Professional billing experience highly preferred.

Experience/Skills Sought:

• English speech, spelling, grammar, and simple math skills equivalent to high school level required.
• Ability to perform relevant mathematical calculations.
• Must possess computer competency.
• Detailed knowledge and understanding of regulatory and CSHS policies and procedure governing billing and collections.

Physical Demands:

• Sit at a desk or table with some walking, standing, bending, stooping, or carrying of light objects.
• Perform continuous operation of a personal computer for four hours or more.
• Use hands and fingers to handle and manipulate objects and/or operate equipment.