Revenue Cycle Specialist

Graham Regional Medical Center•Graham, TX

15d•Onsite

About The Position

The Revenue Cycle Specialist assists with various financial tasks, specifically payment and collections, for the hospital. INTERACTION Primarily Interacts with: administration, providers, employees, clinical and non-clinical departments, patients, and insurance companies. ESSENTIAL FUNCTIONS Work with providers and patients as necessary for enrollment, patient financials, or eligibility and authorization. Obtain appropriate demographic and insurance/billing information from the patient and ensure accurate data entry. Verify patient eligibility and/or benefits; follow up with the patient and their health plan to determine if the patient is covered. Complete or obtain insurance verifications and obtain authorizations or referrals as required. Engage directly with patients to explain their bills, resolve billing inquiries, and collect payments or set up payment plans for outstanding balances, ensuring a positive customer service experience. Research any payment discrepancies. Work queues are in the appropriate module. Handle denials and appeals of claims. Post payments received and make financial adjustments as appropriate. Post in the General Ledger and Accounts Receivable system. Pull the explanation of benefits electronically and process accordingly. Pick up mail from the post office and process incoming mail daily. Uploads EMS mail into the Digitech FTP Scan all the supporting documentation. Upload correspondence and payments to Ditech daily. Maintain records for the financial department on a cash flow spreadsheet. Distribute payment receipts to the appropriate department managers. Prepare the bank deposit daily and take it to the bank. Send out the daily cash log. Create client invoices and send out the bills monthly. Process refunds. Balance petty cash daily. Pull bank deposit transactions daily from the banks. Upload reports daily to the appropriate FTP. Create reports as required. Process charity care applications. Run reports monthly and process them. Process worker compensation and MVA accounts. Process the payroll deduction report received from HR biweekly. Process and send billing records. Assist with special projects as assigned. Maintain the confidentiality of patient information in compliance with HIPAA. Provide exemplary customer service. Cooperate with other personnel to achieve departmental objectives and maintain good employee relations, inter-departmental objectives, and infection control policies. Cordially demonstrate timeliness and professionalism in appearance, communications, and actions during all interactions and with all individuals and entities. Solve practical problems, dealing with a variety of issues, and interpret a variety of instructions furnished in written and oral form. Attend meetings as required. Perform other duties as requested or assigned.

Requirements

Minimum High School diploma or GED required.
Two years of similar experience required in a healthcare setting.
Experience with and understanding of medical and insurance terminology required.
Must be able to adapt quickly to changing situations.
Ability to analyze information and make decisions using reasonable and logical judgment.
Excellent command / highly proficient in spoken and written English; bilingual in Spanish preferred.
Intermediate computer skills, including but not limited to: Microsoft Office – in particular Excel, electronic medical documentation, and email.
Strong mathematical skills required.
Must be able to adequately and quickly learn new software programs and serve as a Super User.
Must be committed to quality and patient safety at all times.
Must be able to communicate face-to-face and/or over the telephone.
Must be able to work independently, and flexibly, and as a part of a multidisciplinary team.
Must be able to manage several interruptions throughout the shift.
Must have strong interpersonal and communication skills, verbal and written.
Must have strong time management skills.
Must be able to work under pressure while interacting in a helpful, courteous manner with a high degree of patient contact.
Sufficient hearing, vision and dexterity to perform duties safely.

Nice To Haves

College-level coursework in accounting or related field preferred.
Excellent command / highly proficient in spoken and written English; bilingual in Spanish preferred.

Responsibilities

Work with providers and patients as necessary for enrollment, patient financials, or eligibility and authorization.
Obtain appropriate demographic and insurance/billing information from the patient and ensure accurate data entry.
Verify patient eligibility and/or benefits; follow up with the patient and their health plan to determine if the patient is covered.
Complete or obtain insurance verifications and obtain authorizations or referrals as required.
Engage directly with patients to explain their bills, resolve billing inquiries, and collect payments or set up payment plans for outstanding balances, ensuring a positive customer service experience.
Research any payment discrepancies.
Work queues are in the appropriate module.
Handle denials and appeals of claims.
Post payments received and make financial adjustments as appropriate.
Post in the General Ledger and Accounts Receivable system.
Pull the explanation of benefits electronically and process accordingly.
Pick up mail from the post office and process incoming mail daily.
Uploads EMS mail into the Digitech FTP
Scan all the supporting documentation.
Upload correspondence and payments to Ditech daily.
Maintain records for the financial department on a cash flow spreadsheet.
Distribute payment receipts to the appropriate department managers.
Prepare the bank deposit daily and take it to the bank.
Send out the daily cash log.
Create client invoices and send out the bills monthly.
Process refunds.
Balance petty cash daily.
Pull bank deposit transactions daily from the banks.
Upload reports daily to the appropriate FTP.
Create reports as required.
Process charity care applications.
Run reports monthly and process them.
Process worker compensation and MVA accounts.
Process the payroll deduction report received from HR biweekly.
Process and send billing records.
Assist with special projects as assigned.
Maintain the confidentiality of patient information in compliance with HIPAA.
Provide exemplary customer service.
Cooperate with other personnel to achieve departmental objectives and maintain good employee relations, inter-departmental objectives, and infection control policies.
Cordially demonstrate timeliness and professionalism in appearance, communications, and actions during all interactions and with all individuals and entities.
Solve practical problems, dealing with a variety of issues, and interpret a variety of instructions furnished in written and oral form.
Attend meetings as required.
Perform other duties as requested or assigned.