AR & Revenue Performance Specialist II

Catalyst Health Group•Amarillo, TX

2d•Onsite

About The Position

The AR & Revenue Performance Specialist II is a cornerstone of our Revenue Operations Center (ROC), where we have retired the traditional "billing utility" identity to launch a mission-driven Solution Center. You will help our team thrive by ensuring every dollar earned is captured, protected, and realized-directly enabling the financial performance that supports our organization. We are a culture unabashedly driven by purpose, making a material difference for our providers and patients by prioritizing final financial outcomes over simple manual task-processing. We are looking for high-performance professionals who want to move beyond "activity" to drive true financial performance. Every day, we support the health journey of patients by authentically living our core values: Purpose Driven, Relationships Matter, Serve Others First, and Inspire Creativity. If you love serving others and would like to make a material difference in an industry-transforming organization, then we invite you to apply to this role. We are recognized as one of the Top 100 Places to Work by The Dallas Morning News, and we have been awarded as one of the fastest-growing privately held companies by SMU Cox.

Requirements

High School diploma or equivalent required.
Minimum two (2) years insurance resolution experience resolving issues with patients and payers as well as four (4) years combined medical billing and payment experience required.
Proven ability to work independently to resolve difficult billing and coding issues through to completion.
Demonstrate knowledge of state, federal, and third-party claims processing required.
Demonstrate knowledge of state & federal collections guidelines.
Demonstrate knowledge of medical coding
Proficiency with computer systems and Microsoft Office (Word and Excel) required.
Proficiency navigating and managing EMRs

Nice To Haves

6 years revenue cycle experience preferred.
Transcript for Medical and Billing Training course or certification.
Associate degree in finance, Business

Responsibilities

Maximize Cash Realization: Lead efforts to ensure every dollar earned is captured and successfully deposited. Monitors accounts and performs appeals, coding corrections, payment application, refund management and collection duties in the practice management system.
Complex & Patient AR Resolution: Serve as the primary point of escalation for high-complexity insurance obstacles and escalated patient billing questions that require strategic intervention.
Call Center & Billing Support Optimization: Drive front-line proficiency by coaching call center staff on revenue cycle fundamentals and providing the technical support needed to resolve patient inquiries at the source.
Systems Performance & EMR Optimization: Ensure the Practice Management (PM) and EMR systems are optimized to drive the highest possible level of financial outcome and operational efficiency.
Advanced Recovery: Execute advanced denial management strategies and complex appeals to secure payment on high-dollar or aged claims.
Independent Root Cause Analysis: Perform comprehensive account-level research to identify why claims are failing and implement strategic fixes to resolve them.
SOP Development: Draft and deploy technical resolution playbooks and training materials to standardize workflow for the Revenue Operations Center.
Trend Identification: Spot recurring payment or billing errors and collaborate with Coordinator leadership to address the source of friction.
Patient Financial Liaison: Act as the senior technical resource for the billing department to resolve escalated patient account questions, providing clarity on complex balances and insurance adjustments.
Call Center Mentorship & Coaching: Partner with call center leadership to provide regular coaching and develop "Quick Reference" guides that empower agents to answer basic patient billing questions accurately.
Peer Mentorship and Training: Act as a technical and training resource for Tier 1 Specialists, providing guidance on complex payer rules to improve overall team mastery.
Portfolio Integrity: Monitor delinquent accounts, resolve billing errors, and ensure all payment postings and account balances are accurate.
Quality Assurance: Conduct technical reviews of claim resolutions to ensure adherence to the established ROC mastery standards.
EMR Utilization & Workflow Enhancement: Audit and refine system workflows, work-queues, and automated billing rules to reduce manual intervention and accelerate the billing life cycle.
Compliance: Adhere to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient records.