Biller / Revenue Cycle Management Specialist

Overview

Job Summary: The Revenue Cycle Management Specialist is to support the process of the company's billing function.

Responsibilities

Job Duties:

• Report any misconduct, suspicious or unethical activities to the Compliance
• Ensure verification of current coverage with third party payers and obtain authorizations as
• Assist in the preparation and submission of claims for payment from third party payers, and invoices for patient co-payments.
• Support the resolution of billing issues such as claim resubmissions to all payers, changes in coverage, and claims
• Communicate as required with patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries about
• Review and approve refunds of third-party payer and patient overpayments.
• Assist in record keeping so that all information is accurate and complete and manage the flow of up-to­ date information between billing department and other parts of the company, such as the accounts receivable, accounts payable and customer service
• Ensure the implementation of processes to measure, assess, and improve the performance of the billing department activities of the company.
• Review and suggest changes to billing department policies and procedures as needed.
• Ensure ongoing compliance with all laws and regulations; ensure that the department meets or exceeds accreditation standards; and implement "best practices" in all departmental \
• Participate in surveys conducted by authorized inspection
• Participate in the company's Performance Improvement program as requested by the Performance Improvement
• Participate in company committees when
• Participate in in-service education programs provided by the company.
• Pursue continuing education programs appropriate to job
• Perform other duties as assigned by
• Responsible for completing all mandatory and regulatory training programs
• Perform other duties as assigned

Qualifications

Educational Requirements:

• High school diploma or GED

Experience:

• One to three years of experience in Home Nursing/Services or related organization

Credential/Licensure Required:

• Must be a licensed driver with an automobile that is insured in accordance with state and agency requirements and is in good working order

Special Conditions of Employment:

• Criminal background check and/or drug test
• Initial and continuous exclusion and sanction/disciplinary monitoring

Required Training:

• HIPPA Privacy Course
• HIPPA Security Course

Job Skill Requirements:

• Complies with accepted professional standards and practice
• Has satisfactory references from current employers and professional peers
• Has excellent observation and communication skills
• Is self-directed with the ability to work with little supervision
• Is flexible and cooperative in fulfilling obligations

Management Skills Required:

• Customer Service: Must provide timely and accurate responses to all business associates and customers
• Planning: Must develop effective plans, objectives and goals that achieve desired results in a timely manner
• Organization: Must organize work in a systematic way, establish clear lines of responsibility, and delegate effectively
• Communication: Must write and speak clearly and effectively at all levels, listen and be attentive to others
• Decision Making: Analyze data and make and/or implement effective decisions in a timely manner
• Technology: Must use technology to its fullest potential to achieve department and corporate goals

Leadership Skills Required:

• Leadership: Gains acceptance of ideas and accomplishes goals through subordinates, peers and teams
• Personnel Development: Selects, trains, coaches and develops associates and teams for peak performance
• Teamwork: Must strengthen team performance by sharing information, establishing guidelines and celebrating success
• Empowerment: Demonstrates positive and active ownership of one’s responsibilities and fosters the same in others
• Employee Relations: Provides and solicits constructive feedback, evaluates performance and takes corrective action

Behavioral Traits:

• Intuitive/Open minded: Must be able to see opportunities, develop and implement creative solutions to complex problems
• Achievement Drive/Commitment: Driven to achieve goals, objectives and results. Fosters a culture of continuous improvement
• Positive/Supportive: Inspires and shows faith in others, builds a positive and supportive work environment
• Flexibility: Ability to adapt to changing business needs. To balance multiple priorities and deliver under pressure

Compensation

$21.00-21.50 per hour.

The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience and education.  

KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state and federal regulations as it pertains to minimum wage requirements.