Revenue Cycle Management Specialist I

Legacy Community Health•Houston, TX

About The Position

Join Legacy Community Health as an RCM Specialist I and be at the forefront of transforming healthcare revenue management. In this pioneering role, you will immerse yourself in a dynamic, tech-driven environment, leveraging cutting-edge tools and data analytics to optimize revenue cycles and enhance patient experiences. Role highlights: Innovate revenue cycle management with state-of-the-art technology. Work environment benefits: Collaborate in a forward-thinking, supportive team atmosphere. Impact and growth opportunities: Contribute to groundbreaking changes in community healthcare with potential for career advancement. Team collaboration: Engage with a network of skilled professionals and stakeholders to drive sustainable solutions. Mission-driven: Play a critical role in digitizing healthcare operations to support patient dignity and privacy.

Requirements

High School diploma or equivalent; 1-2 years of experience in medical revenue cycle management.
For Legacy internal candidates, 3 years of patient-facing experience required.
Proficient in insurance verification processes, with some training in ICD10/CPT codes.
Basic proficiency in Excel to support data analysis and digital workflows.
Strong ability to manage multiple deadlines and prioritize tasks in a fast-paced environment.
Commitment to continuous learning and adaptation in a rapidly evolving healthcare sector.
Reasonable accommodations made for individuals with disabilities to perform essential functions.

Nice To Haves

EPIC Certification preferred; experience with EPIC systems desirable.

Responsibilities

Assess and verify the accuracy of demographic and policy information in patient accounts.
Digitally capture and process patients' identification and insurance documentation efficiently.
Respond proactively to patient account inquiries via digital platforms and phone communications.
Maintain comprehensive digital records of all communications and transactions within patient accounts.
Assist in patient collections and reconcile deposits using data-driven insights.
Conduct daily verifications of patient insurance eligibility and authorization requirements.
Determine insurance plan benefits for scheduled procedures, leveraging digital tools.
Obtain clinical histories digitally from referring physicians to facilitate authorization processes.
Adhere to digital documentation guidelines for eligibility, authorization, and benefits information.
Communicate non-covered benefits or exam coverage issues effectively with patients and physicians.
Guide Clinic Staff and Scheduling Staff on digital authorization and eligibility processes.
Stay informed of and communicate updates in payor authorization processes digitally.
Work independently and remotely while maintaining productivity and performance goals.
Participate in continuous education to stay ahead of industry changes and innovations.
Ensure patient information confidentiality in digital environments.
Collaborate with team leads to resolve RCM issues with an agile approach.
Engage in team meetings and special projects with both physical and virtual presence.
Perform other duties as part of an agile, responsive healthcare team.