Revenue Cycle Specialist (Hybrid in Central Oregon)

Central Oregon Pediatric Associates (COPA) of Bend, Oregon, the largest pediatric practice in the region, is hiring a full-time Revenue Cycle Specialist.

This is a hybrid (with potential to become remote) eligible position within Central Oregon. This position is regularly scheduled for Monday - Friday, 8:00am - 5:00pm.

At COPA, the Revenue Cycle Specialist plays an integral role serving patients at our friendly and welcoming medical clinic for children of all ages. The Revenue Cycle Specialist is focused on performing billing functions for pediatric providers. The current priorities of this role include identifying, prioritizing and managing strategic needs for an efficient service workflow and optimal A/R outcomes at COPA.

The role of the Revenue Cycle Specialist will include but is not limited to the following duties:

Maintains an in-depth knowledge of principles, practices, standards, and techniques and demonstrates knowledge in accordance with COPA policies and procedures within pertinent laws and regulations in the following areas:

• Research and resolve Medicaid and commercial denials and no response to claims
• Review and process claims to ensure timely and accurate billing
• Compose and submit claim appeals as required by payor policies
• Perform data entry to record payments and insurance explanation of benefits/payments
• Review guarantor accounts for coverage and demographic issues that may cause denials
• Verify insurance eligibility and benefits
• Create estimates for patients as requested and required
• Post payments in an accurate and in a timely manner
• Conduct collections calls and balance reminders
• Ensure all claims are compliant with federal and state regulations including HIPAA, CMS and payer-specific requirements
• Provide patient account payment reports and other information upon guarantor request
• Participate in departmental trainings on EPIC, customer service and policy/process
• Process claims, or medical records as required by payors
• Assure timely and accurate submission of claims and follow up activities performed to maintain timely payment and data integrity
• Work closely with cross functional teams to resolve duplicate accounts, insurance coverage and benefit questions, and any other issues
• Consistently conduct all activities upholding the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies and procedures, supporting COPA by acting in an ethical and appropriate manner
• Demonstrate exceptional customer service by effectively utilizing communication skills in a manner that supports COPA’s clinic vision, values and mission

Qualifications
Education and Certification:

• High School diploma or GED required
• RHIT or AAPC Certification preferred

Experience:

• 3 years of hospital or healthcare intake/admissions and/or reimbursement experience required. Knowledge of ICD-10, CPT, Revenue Codes, base rates, Medicaid methodologies, HCPCS coding and related governmental guidelines and provider reimbursement methodologies preferred
• Epic EMR experience preferred. Proficient with Microsoft Office Suite
• Bilingual in Spanish and English a plus

Physical Requirements:

• Use of clear and audible speaking voice and the ability to hear normal speech level in person, over the telephone or through use of other required technology. Sitting or standing for long periods of time. Frequent repetitive motion includes computer keyboard use, reaching with hands and arms, and walking. Occasional lifting and or moving up to 30 pounds and on rare occasion up to 50 pounds. Specific vision abilities required include viewing computer monitor for long periods of time, close vision, distance vision, color vision, peripheral vision, and depth perception
• Must be able to wear appropriate personal protective equipment (PPE) as required

Working Conditions:

• Position may qualify to be located local-remote to include periodic on-site meetings and shifts in COPA clinics, business office or community partners.
• Standard medical office; may be eligible for combination of on-site and home office
• Work inside in a general medical office setting with ergonomically configured equipment
• Travel between COPA clinics, business office and community partners as required

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire.

COPA is looking for a candidate with a strong work ethic and a passion for the health of each of our patients. The right candidate will thrive in a private practice where they have the opportunity and flexibility to positively impact the life of a child and their family. If this opportunity resonates with you and you can demonstrate a history of high quality, service-oriented performance, we welcome your application! Please submit a cover letter explaining your desire to work in Pediatrics, your current resume and apply online at www.copakids.com.

COPA is a 5-Star Patient-Centered Primary Care Home, the highest designation, and awarded to clinics which integrate advanced, transformative medical processes and proven best practices for positive patient outcomes. We’re proud of our teams which commit to excellence in a supportive work environment where the patients’ needs come first.

COPA expects all team members, from operations to medical departments, to have a deep commitment to the objectives of COPA, support their fellow team members, and provide the best experience for patients. The right candidate has demonstrated a work ethic that exhibits professionalism while exceeding every expectation of service.

COPA employees are a close-knit group that collaborates to ensure all children are well served. We focus on maintaining a culture of high performance in a personable work environment. The right candidate has a history of positive interactions in team environments, and friendly demeanor toward people of all ages and backgrounds. COPA provides a competitive total pay and benefits package.

About COPA - Central Oregon Pediatric Associates (COPA) has provided excellent, comprehensive and compassionate medical care to children in Central Oregon for over 45 years. Our mission is to provide all children with outstanding medical care and exceed their expectations in a friendly and welcoming environment. COPA is a thriving, independent partnership whose healthcare quality measures exceed all medical care facilities in the region. In addition to pediatric primary care services and procedures, COPA’s Pediatric Center of Excellence also provides behavioral health specialists, lactation services, care coordinators, and newborn patient advocates. We’re committed to serving families where English is not the first language and have interpreters at every location and all shifts. COPA hosts in its clinics over a dozen visiting pediatric specialists from children’s hospitals in Portland, Oregon. COPA has four convenient locations in Bend and Redmond, and is open seven days a week with extended hours, and offers 24/7 telephone pediatric nurse advice.