Revenue Cycle Specialist II

Catalpa Health is a pediatric mental health clinic serving over 8,000 children in the Fox Valley each year. Our team members work diligently to meet the needs of our clients, offering families the support they need at the right time, close to home. Our vision to inspire hope and provide world-class mental health care is our driving force and is realized each day through the actions of our team members.

Building a supportive work environment is at the heart of our values. One way of expressing that support is by providing a comprehensive whole-person benefits plan. We believe in providing resources to our team members to support them in all stages of their life’s journey.

Benefits include:

• Competitive pay
• Referral bonus program
• Multiple health insurance plans designed to meet the needs of your family
• Dental and vision insurance plans
• Short & Long-term disability
• 401-K Plan with Company Match
• Life Insurance, Critical Illness and Accident insurance
• Pre-tax FSA and HSA plans, Dependent Care Saving Plan
• Generous Paid Time Off plus 9 paid holidays each year (Full time employees earn up to 3 weeks in your first year of employment)
• Up to $1500 for Professional development and continuing education annually
• Wellness program through Optum that includes additional resources to support your mental health needs, financial and retirement planning, eldercare support services, and more

Work environment:

• Casual dress code
• Centrally located and close to Fox River Mall
• Fun, supportive and dedicated staff members

Position Description:

The Revenue Cycle Specialist II is responsible for preparing, submitting and maintaining enrollment, credentialing and re-credentialing documentation for Catalpa Health’s providers to ensure licensing and certification requirements are met. Credentialing activities will be approximately 50% of this full-time position. The remaining 50% of this position will focus on completing tasks associated with completion of the revenue cycle process.

Essential Functions and Responsibilities:

• Manage and complete all aspects of credentialing processes Including but not limited to the following:
  • Manage new and renewal credentialing applications per payor guidelines
  • Create and maintain an internal credentialing file for each provider
  • Manage and maintain records related to malpractice COI’s for providers.
  • Update payer rosters quarterly
  • Complete review of Office of the Inspector General (OGI) reports
• Complete prior authorization process for services
• Completes daily work processes of revenue department related to claim submission and edits, insurance verification, payment plans, account adjustments, billing and collections, and financial assistance

Education, Experience and Certification(s):

• High school diploma or equivalent
• Minimum of 2 years of experience in health care credentialing, billing and insurance tasks
• Previous experience with electronic medical record software, specifically Epic - Resolute
• Certified Revenue Cycle Representative, Billing Specialist or Health Information Technician (Preferred)

Skills and Abilities:

• Strong attention to detail and accuracy in data entry
• Excellent written and verbal communication skills
• Understanding of HIPPA
• Experience with CMS and State of WI Medicaid Billing
• Able to prioritize work and meet deadlines
• Proficient with MS Office applications

Catalpa Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.