What are the responsibilities and job description for the Revenue Cycle Claim Specialist position at Eau Claire Cooperative Health Center Inc?
Company Overview: Eau Claire Cooperative Health Center, Inc. (dba Cooperative Health) is a leading community health center serving the Midlands of South Carolina since 1981. It is deeply rooted in its mission of providing accessible, high quality, compassion health care in the spirit of the Good Samaritan. The organization’s values of: treating each other with respect, putting people first, being excellent at what we do, promoting a collaborative work environment, improving community/population health, fostering innovative thinkers, and getting results, are core attributes of every employee at Cooperative Health.
Position Summary: The Revenue Cycle Claim Specialist will be assigned to specific Practice Locations and is responsible for increasing billing efficiency, accuracy and profitability through working Missing Slips and creating claims. Responsibilities will include, review of insurances, billing services, payer specific billing guidelines and other Billing duties and tasks as assigned by Revenue Cycle Supervisor, Sr. Lead Revenue Cycle Specialist and/or Revenue Cycle Director. This position may be considered for a future hybrid schedule.
Principles Responsibilities:
- Effectively communicates with Revenue Cycle Leadership staff to clarify coding and billing for accuracy.
- Track and report insurance, billing and coding errors that impact claim creation.
- Report identified coding and practice management system issues to Revenue Cycle Leadership.
- Attend required Revenue Cycle meetings in person and/or via Zoom or Teams.
- Perform daily Encounter review to assure general documentation supports coding on Superbills.
- Perform Daily Day End review to identify the need for additional claim edits and validate charges.
- Review and prepare claims for submission to various insurance carriers.
- Responsible for responding to emails and Athena text pertaining to claim corrections.
- Responsible for performing other billing task as directed by Revenue Cycle Leadership.
Competencies:
- Ability to embody the mission and vision of Cooperative Health.
- Excellent written and verbal communication and problem solving skills.
- Ability to communicate with people from a variety of socioeconomic and cultural backgrounds.
- Ability to prioritize, organize and carry out work assignments independently and efficiently.
- Ability to maintain appropriate degree of confidentiality.
Education & Experience:
- Education – Min. High School Diploma with some college
- Minimum 2 years working Registration in a Physician’s office
- Minimum 1 year experience performing Patient Check-in/Registration (Athena experience required)
- Minimum 1 year experience performing Claim Creation (Athena experience required)
- Minimum 2 years Medical Billing and Insurance experience.
- Training or working knowledge of ICD-10 and CPT coding.
- Current working knowledge of Medical software (Athena)
- Knowledge of FQHC Billing
Physical Demands:
- Prolonged periods sitting or standing
- Must be able to lift up to 25 pounds
- Be able to sit, stand, stoop, squat for extended periods of time throughout the day
- Standing or walking for extended periods throughout the day
Company Conformance Statement
In the performance of respective job assignments, all employees are required to conform with Cooperative Health’s:
- Board approved policies and procedures;
- Confidentiality and professional provisions;
- Compliance program; and
- Standards of conduct.
**Cooperative Health provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Cooperative Health complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfers, leaves of absence, compensation and training
