RCM - Billing Specialist

Angel MedFlight•Scottsdale, AZ

9h•$0 - $24

About The Position

The RCM - Billing Specialist manages the billing process and coordinates root cause analysis between Flight Coordination and follow-up to support maximum reimbursement to MHP. The position serves as a company focal point for revenue cycle activities, Quality Assurance, and Billing. The specialist develops and analyzes revenue-cycle and accounts-receivable reporting, identifies reimbursement opportunities and payor trends, and recommends corrective actions and procedural changes. The role works with payors, follow-up personnel, Legal, Flight Coordination staff, revenue-cycle leadership, and senior leadership to improve collections, ensure accurate payment and billing, and advance departmental performance. It also supports quality assurance, drives revenue-cycle meeting agendas and action plans, and directs reimbursement staff projects with the Revenue Cycle Director.

Requirements

High school diploma or GED; coding certification or a higher level of education.
Five to seven years of experience in a healthcare environment or related billing, auditing, and reimbursement work, or related experience and/or educational accomplishments, with knowledge of project management, data analytics, and Salesforce; a combination of experience and education will be considered.
Working knowledge of registration, billing, insurance follow-up, and commercial insurance analysis.
Strong communication and analytical skills, ability to work independently, and ability to handle multiple tasks.
Ability to manage staff and understand and adhere to human resource guidelines.

Nice To Haves

Bachelor’s degree.
Process-improvement skills, such as Lean, Six Sigma, or Process Excellence.
Healthcare and revenue-cycle experience, including medical billing and collections.
Experience reviewing 1500 claims.
Salesforce.com experience.
Knowledge of collections, reimbursement, and Salesforce.

Responsibilities

Develop recurring reimbursement and revenue-cycle reports, including target-versus-actual collection rates and actual-versus-target A/R days; troubleshoot Salesforce Workbench reports and train staff to report effectively.
Analyze workflows and operational procedures, identify reimbursement improvements, and develop and implement procedures to ensure services are captured, recorded, processed, and billed accurately and promptly.
Analyze monthly A/R reports by payor and monitor department performance; recommend corrective follow-up, procedural changes, and payor negotiations.
Ensure payments are received, credited, and recorded at contracted rates; research discrepancies and provide feedback to leadership.
Analyze billing and accounts-receivable reports, identify payor trends and aged-receivable categories, and provide departments with action plans to improve results.
Work with payors and follow-up personnel to provide training on revenue-cycle metrics.
Work with Legal to help ensure proper payment is received.
Analyze reimbursement and collections reports to identify coding and billing improvements, and recommend new procedures to management.
Monitor insurance cash-collection procedures and educate Flight Coordination staff on best practices.
Provide reports, feedback, and analysis concerning reimbursement-related quality assurance functions.
Meet with revenue-cycle leadership to address reimbursement and data needs and recommend target areas for analysis.
Understand vendor revenue-cycle contracts, track and trend vendor effectiveness, and provide feedback to revenue-cycle leadership.
Present reimbursement findings, action plans, and opportunities to senior leadership.
Drive revenue-cycle meeting agendas, create action plans, and follow up on department meetings.
Direct reimbursement staff projects and reporting priorities with the Revenue Cycle Director.
Help ensure revenue-cycle goals and productivity standards are met for optimal utilization.
Help identify methods to improve service delivery.