Finance - Revenue Cycle Specialist

ArchWell Health • Nashville, TN

6d

About The Position

The Revenue Cycle Specialist provides support of all aspects of Revenue Cycle Services and is responsible for supporting the efficiency and effectiveness of revenue cycle operations including vendor and MA plan partner collaboration to meet service level agreements and key performance indicators. The Revenue Cycle Specialist will assist in developing new and emerging approaches for our business processes, projects, and initiatives which will include deliverables that drive financial profitability and meet or exceed margin thresholds. This position reports to the Revenue Cycle Director and will be responsible for supporting the day-to-day revenue cycle operations. This role will collaborate with our clinical, operations and IT teams to drive results.

Requirements

• Deep understanding of revenue cycle functions and requirements in a complex, multi-state setting
• Possess excellent communication skills, both written and oral
• Proven performance results, decision making and judgement
• Experience with external vendors and outsourced billing staff
• Associate’s degree required
• 3+ years of revenue cycle experience in physician office setting
• Coding certification (CPC, COC, CCS, CCA, CPB, CBCS) required or completed within 6 months of hire
• Embodies and serves as a role model of ArchWell Health’s Values:
• Be compassionate
• Strive for excellence
• Earn trust
• Show respect
• Stay resilient
• Always do the right thing

Nice To Haves

• Extensive knowledge of eClinicalWorks strongly preferred
• Experience with capitated reimbursement models strongly preferred

Responsibilities

• Support rapidly growing outsourced billing and coding teams, and identify ideal operating process flows as needed for scalability and optimization
• Assist in developing strong internal processes and documented workflows in support of the revenue cycle, and ensure appropriate integration with field operations
• Continually seek ways to improve the delivery and support of revenue cycle activities and provide recommendations for changes to proactively identify process improvement and eliminate barriers to success
• Provide eligibility and insurance verification support to centers
• Investigate and resolve issues related to patient coverage, effective dates, and missing enrollment information by contacting insurance companies, patients, and other departments. Maintain accurate patient demographic and insurance data in EHR
• Confirm member co-pays, deductibles, coinsurance are accurately captured and collected
• Support all aspects of coding and billing to ensure legal and compliance standards
• Conduct internal audits of billing and coding practices. Provide regular cadence reporting to compliance.
• Ensure adherence to CMS and payer specific regulations
• Assist in building strong relationships with key stakeholders including finance and accounting, IT and field clinical operations.
• Assist in the development of training materials and deliver in person training as needed to our field personnel as we open new centers
• Occasional travel will be required (5-10%)

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree