What are the responsibilities and job description for the Senior Revenue Cycle Operations Specialist position at Azalea Health?
In Summary...
The Revenue Cycle Senior Operations Specialist provides Revenue Cycle Management/Medical Billing services for Azalea clients and operates under the direct supervision of the Revenue Cycle Operations Manager. Duties will include backend processes including but not limited to ensuring unapplied payments are posted, hold credits, sending of patient statements, auditing of RCM functional teams, or other various tasks as needed.
What You Will Do...
Azalea Health is an Equal Opportunity Employer committed to creating a diverse and inclusive workforce where our employees excel based on merit, qualifications, knowledge, ability, and job performance. We embrace and encourage our employees' differences in age, color, disability, ethnicity, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socioeconomic status, veteran status, and any other characteristics protected by federal, state, and local laws that make our employees unique.
The Revenue Cycle Senior Operations Specialist provides Revenue Cycle Management/Medical Billing services for Azalea clients and operates under the direct supervision of the Revenue Cycle Operations Manager. Duties will include backend processes including but not limited to ensuring unapplied payments are posted, hold credits, sending of patient statements, auditing of RCM functional teams, or other various tasks as needed.
What You Will Do...
- Analyzes Explanation of Benefits and/or payor correspondence to reconcile system credit balances or potential over-payments by insurance payers and/or patient.
- Perform audits and analysis of credit balances to ensure accuracy and efficiency of the RCM Teams
- Identify trends with overpayments and communicate trends to Management
- Research and resolve problem accounts on HOLD status
- Review unapplied payments for client and post to the appropriate encounter
- Reviews accounts pending collections and assists client in sending to collection agency
- Submit statements for patient balance due for processing
- Address Client Tasks and Cases assigned to RCM Operations in a timely manner
- Identify and apply adjustments to encounters per documentation provided
- Deploys internal audit techniques in the RCM Operations department to effectively monitor and oversee quality assurance within our team
- Communicates and records trends, analysis, & areas of improvement to RCM employees and management
- Communicate with Customer Success Management regarding trends and issues that could affect client satisfaction and revenue.
- Demonstrates a good working knowledge of CPT, ICD10, and HCPCS codes as well as remaining current on regulatory coding changes.
- Maintains HIPAA compliance when handling patient protected health information (PHI)
- Effectively monitors and audits RCM activities being performed by 3rd party subcontractors both domestic and overseas.
- Assist with the innovation of the Azalea Ambulatory Platform to increase automation and efficiency for the end users.
- Responsible for other Revenue Cycle Management-related duties as assigned
- Associates degree in healthcare management field preferred; CPC, CPB or CPMA designation preferred
- Minimum 3 years experience in Revenue Cycle Management with 1 year minimum experience in data analysis
- Proficient in Microsoft Excel
- Excellent ICD-10, CPT, and HCPCS coding knowledge & skills
- Excellent computer and internet skills/instincts
- Strong analytical and problem-solving skills
- Being curious; having an interest in the revenue cycle management/healthcare administration industry, being excited to learn new things
- Being customer success oriented and focused, but also willing to raise red flags
- Being adaptable; issues will occur and projects will change so being amenable to meet those challenges is required
- Demonstrating the ability to work independently, but also able to ask for help when needed
- Demonstrating humility; partnership and ability to receive feedback and suggestions for improvement
- Having a sense of urgency; time is of the essence for our customers
- Competitive and comprehensive benefits: Coverage options to support the whole person, including full medical, dental, vision, and life insurance
- Generous employer sponsored subsidy towards employee's medical insurance premiums
- Azalea Health covers 100% of the premiums for Life AD&D and Long-Term Disability for all eligible full-time employees
- Balance and flexibility: Simple Paid Time Off (PTO) options. You earn your time, use it as you choose.
- Economic opportunity: Competitive total rewards package that offers competitive pay and advancement opportunities
Azalea Health is an Equal Opportunity Employer committed to creating a diverse and inclusive workforce where our employees excel based on merit, qualifications, knowledge, ability, and job performance. We embrace and encourage our employees' differences in age, color, disability, ethnicity, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socioeconomic status, veteran status, and any other characteristics protected by federal, state, and local laws that make our employees unique.