Revenue Cycle Management Specialist-Medicine

University of Maryland Emergency Medicine•Baltimore, MD

About The Position

The Revenue Cycle Specialist (RCMS) is a multi-disciplinary role, which combines work from 3 key revenue cycle functions within the Department of Medicine’s Billing Office (DOMBO): coding/auditing, charge entry, and payment posting. The RCMS reports to the Manager, Accounts Receivable, who collaborates with the Manager, Charge Entry and Supervisor, Coding to determine work allocation to ensure that he RCMS is focusing on the greatest need that supports initiatives within the Department of Medicine and DOMBO. The RCMS is responsible for abstracting and coding notes/encounters, entering patient demographics, insurance information, professional charges and posting and reconciling payments into the professional billing system for services rendered by Department of Medicine (DOM) Physicians and Advanced Practice Providers (APP). The RCMS ensures that all information entered in the professional fee billing system is precise and accurate; and other duties as assigned.

Requirements

High school diploma or general education degree (GED) preferred
Certified Professional Coder (CPC) or Certified Professional Coder-Apprentice (CPC-A)
Two or more years of experience in a medical billing office
Experience with resolution of claims edits preferred
PC proficiency, to include but not limited to, MS Office software
Knowledge of Athena/GE/IDX, EPIC, or similar computerized billing system
Knowledge of payers in specialty
Knowledge of ICD-10 and CPT coding
Understanding of: FSC's used in Athena/GE/IDX system, contractual requirements for the job; importance of compliance with all government regulations regarding billing.

Responsibilities

Works across 3-4 clinical disciplines and prioritizes areas of greatest need/focus. Ability to navigate complex disciplines with multiple locations, billing areas, and/or special workflows.
Selects the appropriate procedural and diagnostic code based on provider documentation, utilizing HIPAA Standardized Code Set and applying CMS/payor guidelines.
Ensures that teaching physician documentation and billing requirements are met and are clearly reflected.
Review provider coding and provide training and feedback on coding questions and issues.
Collaborates with Accounts Receivable team with denials and charge correction requests as needed.