REVENUE CYCLE SPECIALIST I

GALEN MEDICAL GROUP PC•Hixon, TN

2d•Onsite

About The Position

The Revenue Cycle Specialist I is responsible for overseeing the revenue cycle activities between Galen Medical Group and RCM Support Team (which is our external billing company).

Requirements

Promote the mission, vision, and values of Galen Medical Group.
Maintain confidentiality of all patients’ medical, financial, and legal information.
Report to work on time and as scheduled.
Wear identification during work hours.
Represent the organization in a positive & professional manner.
Ability to handle difficult situations involving patients, physicians, or others in a professional manner.
Ability to work independently, exercise creativity, be attentive to detail, and maintain a positive attitude.
Comply with all organization policies and standards regarding ethical business practices.
Participate in performance improvement and continuous quality improvement activities.
Attend regular staff meetings and in-services as directed by your manager.
Consistently demonstrate the value of team concept.
Ability to manage multiple and simultaneous responsibilities.
Complete assignments efficiently and in a timely manner.
Understands and abides by OSHA, HIPAA & CLIA standards.
High school graduate or equivalent.
Must be computer literate.
Ability to perform mathematical calculations.
Above average spelling skills.
As part of the Galen Medical Group, the applicant must be a team player and provide excellent customer service while assessing our patient's needs efficiently.
Perform all duties in compliance with Galen Medical policies, HIPAA, and OSHA standards.
As part of the hiring process, a pre-employment drug screen is required.

Nice To Haves

Two to three years’ medical billing, coding, A/R collection experience.
Medical experience and terminology helpful but not required.

Responsibilities

Coordinates all functions of the external RCM support team to ensure IKS, site, and their assigned tasks are completed in an efficient and timely manner.
Monitors assigned AR to ensure claims are refiled properly and timely.
Analyses reports for trends and workflow issues related to assigned AR.
Works with RCM support team to ensure projects and meetings are productive and complete.
Work with Management team and Providers to make sure their concerns are answered.
Assist RCM Support as needed with coding corrections etc.
Answer CSR phone calls as needed to address patient questions regarding their account.
Monitor assigned sites to make sure RCM process is flowing smoothly, charges are going out, denials are worked, etc.
Make recommendations for any improvements in workflow, denial management, etc.
Review Waystar rejections weekly for denial trends and notify appropriate dept/staff of issues.
Exhibit a high-level production by assuring all assigned tasks are corrected and rebilled in a timely and helpful manner.
Assures external RCM support staff duties and tasks are completed in a timely and accurate manner: Appropriate personnel are notified upon completion of assigned tasks. (coding, billing issues and workflow).
Review with Management team and providers that all rejections or denials for demographic, coding and insurance information are obtained, updated, and entered accurately into the practice management system (PM), and eligibility has been done on presented insurance information.
Knowledge of participating insurance plans accepted by the office.
Actively participate in process improvement efforts.
Serve as a liaison between the external RCM team and onsite teams
May be required to assist other team members based on office demands.
Must always adhere to HIPAA guidelines to maintain the highest level of patient confidentiality.
Other duties as assigned by the Revenue Cycle Manager.