Revenue Cycle Specialist

Description

PURPOSE

Tri-Cities Chaplaincy guides our community members to live their best lives, even and especially through the end of life. The types of people who thrive here are highly committed and place value on service to others and strive for improvement. We are caregivers in service to our clients, patients, families, and each other.

The Revenue Cycle Specialist is responsible for overseeing the revenue cycle process in a healthcare setting. This includes managing billing, credentialing, insurance verification, track accounts receivable, handle payments, and prior authorizations to ensure the financial health of the organization.

Note regarding the listed pay range:

At Tri-Cities Chaplaincy, we carefully establish salary ranges for our positions by taking various factors into account, including education, certifications, knowledge, skills, experience, and market conditions. These ranges are tailored to match the diverse programs and services we offer. Our goal is to ensure fair compensation for candidates based on these factors while maintaining internal peer equity.

Pay Range:$22.18/hr - $35.49/hr

Starting Pay for this Position: $22.18/hr - $28.83/hr

BENEFIT INFORMATION 

· Mileage reimbursement at $.67 per mile.

· Vacation hours accrued each pay period based on hours worked can earn up to 17 vacation days in your first 12 months of employment.

· Sick time earned on an accrual basis at .04615 per hour worked. 90 day hold before using accrued sick leave.

· Ten recognized paid holidays - no waiting period for new hires.

· Health Benefits start the first of the month following your start date.

· Health Benefit Options: Medical, Dental, Vision, Supplemental Life, Accidental Death and Dismemberment, Pet Insurance, Globe Life and Life Flight.

· Agency-covered benefits include Basic Life Insurance and Accidental Death and Dismemberment at 1xAnnual Salary, Long Term Disability, and Short-Term Disability.

· 401k: Up to 5% employer matching after 1 year of continuous employment for eligible employees.

· Full-time employees may be eligible for Public Service Loan Forgiveness (PSLF) https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service .

· Premium pay for bilingual in Spanish; verified through ALTA staff testing.

· Upon review/approval Premium pay for approved certifications.

· Tuition Reimbursement up to $5,000 per year after 12 months of employment  

Requirements

Minimum Position Qualifications

• High School diploma or equivalent.
• Knowledge of medical billing and coding practices.
• Experience with healthcare revenue cycle management.
• Strong understanding of insurance reimbursement processes.
• Excellent communication and interpersonal skills.
• Attention to detail and accuracy in data management.
• Familiarity with healthcare compliance regulations.

Preferred Position Qualifications

• AA Preferred
• Billing certification (e.g., CPC, CCS).
• Experience with healthcare billing software.
• Knowledge of ICD-10 and CPT coding systems.
• Experience with an Electronic Health Records (EHR)/Electronic Medical Record (EMR)

AGENCY REQUIREMENTS

1. Demonstrate support and adherence to the agency’s Mission, Vision, and Values.
2. Participate in community Education and Outreach to raise awareness of agency-provided programs including but not limited to hospice care, advanced care planning, and bereavement.
3. Responsible for knowledge and compliance with agency policies, procedures, and practices.
4. Responsible for maintaining and protecting Patient and agency information in a confidential manner. Practice appropriate HIPAA confidentiality by accessing patient-related information on a “need to know” basis only.
5. Reliable personal transportation, and current and valid state driver’s license and vehicle insurance.
6. Satisfaction of state and agency requirements for Tuberculin testing
7. Hepatitis B immunization series, proof of series, or signed declination.
8. Proof of applicable Vaccination(s) on file or approved accommodation/declination as appropriate on file.
9. Must pass a criminal background screening and pre-employment drug screening.
10. Ability to meet the physical demands of the position (see attached physical requirements and environmental conditions).
11. Complete agency and departmental orientation and training program(s).
12. Complete all continued learning, education, policy reviews, and required training by their respective deadlines.
13. Maintain licensure(s) and certification(s), if required for the position.
14.  Available to work as assigned/scheduled.
15. Other duties as assigned.

Responsibilities and Essential Functions

The position typically operates in an office environment within a healthcare environment. May require occasional interaction with insurance representatives.

1) Billing, Coding, and Technology Utilization:

• Review and accurately code medical procedures and diagnoses.
• Prepare and submit insurance claims for reimbursement.
• Ensure compliance with coding and billing regulations.
• Utilize billing and coding software effectively to maximize efficiency.
• Stay current with advancements in healthcare information systems and technology relevant to billing and coding.

2) Quality Assurance, Documentation and Record Keeping:

• Implement and maintain quality assurance measures to ensure accurate coding and billing.
• Conduct regular audits to identify and correct any errors in coding and billing processes.
• Develop and implement plans for handling billing and coding tasks during emergency situations and system downtimes.
• Maintain accurate and organized records of billing and coding transactions.

3) Claims Processing:

• Monitor and track the status of insurance claims.
• Identify and resolve issues causing claim denials or delays.
• Work with insurance companies to resolve claim discrepancies.

4) Financial Analysis:

• Analyze revenue cycle data and identify trends. 
• Generate reports on key performance indicators.
• Provide recommendations for process improvements.

5) Communication and Customer Service:

• Communicate with insurance companies regarding billing inquiries.
• Provide excellent customer service.
• Educate patients/authorized representatives on insurance coverage and payment options.
• Address patient concerns and resolve billing disputes.

6) Regulatory Compliance:

• Stay informed about changes in healthcare regulations and reimbursement policies.
• Ensure compliance with billing and coding guidelines.

Tri-Cities Chaplaincy is an equal opportunity employer and complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Tri-Cities Chaplaincy does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex (including pregnancy, sexual orientation, and gender identity).