Revenue Cycle Specialist Jobs

About The Position

Requirements

• High School Diploma /GED
• 5 years of experience with insurance eligibility and/or authorization process.
• Must be at least 21 years of age.
• Current, unrestricted AZ driver’s license with no more than two (2) minor moving violations or one (1) accident within the past three (3 years).
• Three (3) years of driving experience required.
• Transportation to attend trainings and perform other work-related activities.
• Must be able to pass a criminal background check prior to employment and regular checks for the duration of the employment.
• Ability to obtain and maintain an AZ DPS Level 1 fingerprint clearance card (employer provides).
• Must possess strong knowledge of insurance eligibility, benefit verification, prior authorization processes, and payer requirements, including State Medicaid (AHCCCS), managed care plans, commercial insurance carriers, and Medicare programs and guidelines.
• Must demonstrate excellent customer service, attention to detail, problem-solving skills, computer proficiency.
• Must be self-directed, maintain professional standards and ethics in appearance, communication, and actions, and be sensitive to cultural and linguistic diversity while supporting the organization’s mission, vision, strategic plan, and code of conduct.

Nice To Haves

• Bilingual (Spanish) preferred.

Responsibilities

• Verifies member insurance coverage and eligibility prior to scheduled appointments
• Confirms member benefits, including but not limited to; co-pays, co-insurance and out-of-pocket amounts.
• Provides insurance related information to members and/or staff regarding benefits for commercial insurance, state Medicaid (AHCCCS), Medicare, etc.
• Communicates financial responsibility to members and arranges for payments as needed.
• Accurately inputs and maintains member insurance data into Electronic Health Record (EHR: Netsmart myAvatar NX).
• Obtains prior authorizations related to services for members prior to scheduled appointments.
• Identifies and resolves all insurance related discrepancies pertaining to members via exception reports on a daily, weekly, monthly basis.
• Monitors member insurance renewal/expiration and works with staff and/or members to avoid lapses in coverage for members.
• Works closely with back-end Revenue Cycle staff to minimize eligibility and/or authorization denials.
• Participates in the process of ongoing professional development and meetings.
• Maintains comprehensive communication among all contacts within the agency, members, and external agencies.
• Models professional standards and ethics in accordance with EBF Code of Conduct, Strategic Plan, Mission, and Vision.
• Performs other duties as assigned.

Benefits

• Medical, Dental, and Vision
• 403b and a 50% employer match up to 3%
• Flexible Spending Account and Dependent Flexible Spending Account
• Health Savings Account
• Voluntary Life insurance
• Voluntary Short-term Disability insurance
• Critical Illness insurance
• Accident insurance
• Employer paid life insurance, long-term disability insurance, and Employee Assistance Program