Revenue Cycle Specialist PRN

Description

1. ORGANIZATIONAL DESCRIPTION

The Revenue Cycle Specialist assists with various financial tasks, specifically payment and collections, for the hospital.   

2. INTERACTION

Primarily Interacts with: administration, providers, employees, clinical and non-clinical departments, patients, and insurance companies.

3. ESSENTIAL FUNCTIONS

• Work with providers and patients as necessary for enrollment, patient financials, or eligibility and authorization.
• Obtain appropriate demographic and insurance/billing information from the patient and ensure accurate data entry.
• Verify patient eligibility and/or benefits, follow up with patient and health plan to determine that the patient is covered.
• Complete / obtain insurance verifications and obtain authorizations/referrals as required. 
• Serve as back-up to Accounts Payable Specialist:
• Compile and review accounts payable documents and prepare document batches for processing in Meditech.
• related to the efficient maintenance and processing of 
• Reconcile transactions and accounts to include credit cards and supplier credit memos with hospital debit memos and process them in a timely manner; Investigate and resolve any identified discrepancies.
• Respond to employee and vendor inquiries.
• Process “Positive Pay” transactions by submitting files to the bank.
• Transfer bank funds bi-weekly or as required for payroll.
• Maintain confidentiality of patient information in compliance with HIPAA.
• Provide exemplary customer service.
• Cooperate with other personnel to achieve departmental objectives and maintain good employee relations, inter-departmental objectives, and infection control policies.
• Cordially demonstrate timeliness and professionalism in appearance, communications, and actions during all interactions and with all individuals and entities.
• Solve practical problems, dealing with a variety of issues, and interprets a variety of instructions furnished in written and oral form.
• Attend meetings as required.
• Perform other duties as requested or assigned.

ABILITY TO USE EQUIPMENT, TOOLS, MATERIALS, MACHINES: Computer, telephone, facsimile machine, copier, scanner, printer, calculator, and other standard office equipment. 

Requirements

4. EDUCATION/EXPERIENCE/SKILLS/ABILITIES

Education:

• Minimum High School diploma or GED required.
• College-level coursework in accounting or related field preferred.

Experience:

• Three years of similar experience required in a healthcare setting.
• Experience with and understanding of medical and insurance terminology required.

Personal Job-Related Skills / Abilities:

• Must be able to adapt quickly to changing situations.
• Ability to analyze information and make decisions using reasonable and logical judgment.
• Strong knowledge of Medicare, Medicaid, Managed Care and Commercial Plans required.
• Excellent command / highly proficient in spoken and written English; bilingual in Spanish preferred.
• Intermediate computer skills, including but not limited to: Microsoft Office – in particular Excel, electronic medical documentation, and email.
• Strong mathematical skills required.
• Must be able to adequately and quickly learn new software programs and serve as Super User.
• Ability to read and understand different Explanation of Benefits and explain various insurance terminology.
• Knowledge of revenue cycle: billing, invoicing, payment methods, and collections.
• Must be committed to quality and patient safety at all times.
• Must be effective at adjusting to change, prioritizing duties, handling stress and effectively communicating face-to-face and/or over the telephone.
• Must be able to work independently, and flexibly, and as a part of a multidisciplinary team.
• Must be able to manage several interruptions throughout the shift.
• Must have strong interpersonal and communication skills, verbal and written.
• Must have strong time management skills.
• Must be able to work under pressure while interacting in a helpful, courteous manner with a high degree of patient contact.
• Sufficient hearing, vision and dexterity to perform duties safely.

•  Physical and Mental Requirements:

Physical:     

• Activity Up to % Activity Up to %
• Walking 25 Squatting 10
• Standing 25 Pulling 10
• Kneeling 10 Reaching 35 
• Sitting 80 Lifting up to30 lbs 20 
• Pushing 10 Wrist/Finger Movements 90 
• Bending 25   
• Climbing 10   
•  

Mental:     

• Stress Level Moderate to High 

• Individual position core competencies:
• Quality
• Service Excellence
• Compassion
• Professionalism
• Fiscal Responsibility

Required education within first 60 days (if employee is from outside organization).

• GrahamRMC Orientation
• Department Orientation

• Continuing/Annual Education and Training:
• Falling Star Program
• Safety Storm Program

 5. SUPERVISION

Employees Supervised: __No__ 

6. ADA REQUIREMENTS

An ‘X’ under the most appropriate category is marked and describes any extreme or hazardous working conditions that the job has to work under:

•           Frequency of Condition

Condition 1-33% Description

Extreme Heat X   

Extreme Cold X   

Extreme Swings in Temperature X   

Extreme Noise X   

Working Outdoors X   

Mechanical Hazards X   

Electrical Hazards X   

Explosive Hazards X   

Fume/Odor Hazards X   

Dust/Mite Hazards X   

Chemical Hazards X   

Toxic Waste Hazards X   

Radiation Hazards X   

Wet Hazards X   

Heights X   

34-66% Description

---

67% Description

Working Indoors X 

OSHA Classification:

• Identify with a check the OSHA Job Category that describes this job. The intent is to enhance worker protection by identifying any risk in the performance of routine and reasonably anticipated job-related functions.

_____ Category I: Tasks that involve exposure to blood, body fluids or tissues.

All procedures or other job-related tasks involve an inherent potential for mucous membrane or skin contact with blood, body fluids or tissues or a potential for spills or splashes of them are Category I tasks. Use of appropriate protective measures, such as gloves, masks, goggles, and gown are required for every employee engaged in Category I tasks.

_____ Category II: Tasks that involve no exposure to blood, body fluids or tissues but employment may require performing unplanned Category I tasks.

The normal work routine involves no exposure to blood, body fluids or tissues, but exposure may be required as a condition of employment. Appropriate protective measure, such as gloves, masks, goggles, and gown are readily available to every employee engaged in Category II tasks.

__X__ Category III: Tasks that involve no exposure to blood, body fluids or tissues and Category I tasks are not a condition of employment.

The normal work routine involves no exposure to blood, body fluids or tissues (although situations can be imagined or hypothesized under which anyone, anywhere might encounter potential exposure to body fluids). Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency medical care or first-aid or to be potentially exposed in some other way. Tasks that involve handling implements or utensils, use of public or shared bathroom facilities or telephone and personal contacts such as handshaking are Category III tasks.