Revenue Cycle Accounting Specialist

Description

Job Summary

The Revenue Cycle Accounting Specialist works independently and has strong customer service, analytic and problem-solving skills. This position understands, interprets, and explains payor contracts, and HGH billing and collections policies and practices. The Revenue Cycle Accounting Specialist performs duties which include working together with all community service department managers in preparing, reviewing, and submitting billing claims for Department of Healthcare Services (DHCS) funded programs. Prepares and analyzes related receivable data and trends. Prepares and reconciles all AR accounts and prepares monthly AR reports. Proposes and implements system and process changes related to revenue cycle accounting.

Tasks, Duties, and Responsibilities

The Revenue Cycle Accounting Specialist (DHCS) is responsible for the accuracy of claims billing, invoicing, and cash collections for our Community Services Division. Must have advanced knowledge of government funded programs and services. The Revenue Cycle Accounting Specialist is also responsible for month-end close related to the revenue cycle. Must maintain strong internal controls and compliance and ensure all work is appropriately documented and supported.

• Performs the overall billing tasks for programs funded by the California Department of Healthcare Services (DHCS), including:
  • Ensuring effective flow of client charges through the Paycom system.
  • Ensuring accurate claim submission, via coordination with Program Managers and performing account reconciliations.
  • Thorough follow-up on AR balances, investigating outstanding amounts and appealing denied claims.
  • Reviews and tracks fee schedule changes to ensure fully allowed reimbursement.
• Coordinates the admission/discharge/ transfer of residents in Community Care License (CCL) group homes with Residential Services and Health Services.
• Performs assigned balance sheet reconciliations to ensure accuracy of balance sheet and reduce the risk of financial misstatement or financial exposure.
• Maintains current processes and controls for Billing/AR (Cantata Health Systems, SANDIS), ensuring full utilization of the systems. Recommending and assisting with upgrades, implementations, and changes.
• Assists with the documentation, review, and design of workflows and ensure compliance with company’s policies and procedures.
• Builds and maintains a positive relationship with payor contacts.
• Responds to external and internal customers in a timely and professional manner.
• Prepares schedules and reports as required for use in management reporting, periodic reports, annual cost reports, rate increase requests, and annual financial statement audit.
• Performs other accounting, financial, or administrative tasks as required.
• Participates in special/ad hoc projects as required.
• Regularly attends monthly staff meeting and continuing education sessions as requested.
• Working knowledge of various business systems utilized by department.

Values

Innovation – We encourage creativity and innovation because we believe that by striving for more efficient and effective ways of doing things, we can achieve exceptional results. Our drive for success is shared by all.  Our organization focuses on solutions and refuses to maintain the status quo. We challenge our team to be ahead of industry trends as we strive to lead and not follow.

Collaboration – We believe that working together collaboratively is the foundation of a culture that values teamwork, communication, and cooperation. This belief is central to every part of our business, both internally and externally, and strengthens our community.

Accountability – We take responsibility for our actions and for delivering on our commitments. We believe that by being transparent and accountable, we build trust and maintain the respect of our stakeholders.

Respect – We treat everyone with respect and dignity. We value inclusivity and believe that by upholding a culture of respect, we can foster a positive and supportive work environment. We treat others as we would want to be treated.

Empathy – We value empathy and understanding in all our interactions. We seek to understand the perspectives and needs of our colleagues, clients, and stakeholders to meet them with kindness and compassion.

Qualifications

Knowledge, Skills, and Education

• Associate degree preferred or an additional 3 years of experience considered in lieu of degree.
• At least five years of experience with healthcare billing and insurance payment processes required.
• Advanced knowledge and understanding of Medi-Cal Program and Social Security Program (SSI/SSA) eligibility, application, and billing processes.

• Strong attention to detail and accuracy.
• Proficiency in Microsoft Word, Excel, and Outlook.
• Excellent computer and organizational skills required.
• Read, write, and understand the English language. 

• Able to establish and maintain effective relationships with consumers, families, co-workers, volunteers, vendors, and the public.
• Knowledge of HIPPA Guidelines and Patient Privacy required.
• Able to multi-task and manage work time efficiently.

Physical Requirements/Work Environment

This job operates in a professional office environment.  While performing the duties of the job, the employee is regularly required to use hands and arms.  The employee requires dexterity in using telephone, computer keyboard, mouse and calculator while seated at a desk.  The employee is frequently required to stand, walk, and sit.  The employee may frequently move to interact with fellow employees and/or clients.  Specific vision abilities required by this job include close vision, depth perception and the ability to adjust focus.

Equal Opportunity Employer Statement

Home of Guiding Hands is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with disability.

About HGH

Home of Guiding Hands is a non-profit organization that was established in 1967 by a small group of dedicated and ambitious community members. The Mission of HGH is "to improve the lives of those we serve". We support children and adults in San Diego and Imperial Counties with intellectual and developmental disabilities, such as Down syndrome, epilepsy, autism, and cerebral palsy. We provide a full continuum of care including residential care in specialized group homes, independent living support, respite care, and adult foster home services.  Additionally, we provide early childhood assessments and services, tailored day support, Life Planning workshops, county-wide transportation services, and on-site activities at our resource center.

To see all our available career opportunities please visit: https://www.guidinghands.org/careers/

Salary : $25 - $30