North Mississippi Health Services
Specialist - Revenue Cycle
North Mississippi Health Services, Winfield, Alabama, United States, 35594
Overview
The Revenue Cycle Specialist at North Mississippi Health Services is responsible for facilitating effective Revenue Cycle flow, including bill processing and resolution, denials and appeals management, and recurring reporting to monitor status and performance. This role reports to the Billing Manager and requires experience with third party payers and contracts, strong organizational, analytical, and communication skills to interface with payers, vendors, and staff in claims review, analysis, and resolution to promote payment capture and the financial health of the organization. Job Functions
Billing & Follow Up: Processes billing by receiving, interpreting, processing, and submitting through various edits to third party payors in electronic and hard copy formats. Billing follow up by contacting third party payers or accessing payer portals to determine payment expectations and resolve claim problems. Facilitates information exchange by interpreting payer and patient inquiries to expedite payment. Denial Management: Manages denial receivables to resolve accounts and develops strategy for appeal and follow-up. Analyses denials to determine reasons and identifies trends; reports significant and recurring issues with possible solutions to the Denials Management Supervisor and Billing Manager. Takes corrective action to reduce or eliminate payment issues through procedural improvements. Contract Management: Maintains familiarity with payer methodologies and communicates with NMHS staff; manages paid claims to resolve underpaid accounts; analyzes underpayments and identifies trends with possible solutions to the Denials and Underpayment Manager. Communication: Communicates professionally with third party carriers, vendors, and hospital contacts to promote contractual compliance. Liaison: Contacts insurance companies regarding denial, underpayments, or rejection issues; serves as liaison between payers and hospital departments/physician offices or patients to resolve denials and underpayment issues. Reporting: Assists in preparation of monthly denial and variance reports as requested. Regulation: Adheres to NMHS/NMMC policies, procedures, guidelines, and applicable local/state/federal regulations and laws. Qualifications
Education: Bachelor’s Degree in Business, coding, or equivalent field required. Associate’s or High School with equivalent revenue cycle experience may be considered in lieu of a degree. Licenses and Certifications: (as required by role) Work Experience: 1-3 years Knowledge, Skills, and Abilities
Excellent analytical and problem-solving skills; strong organizational and written/verbal communication skills. Interpersonal skills and computer proficiency (Microsoft Office, Outlook, third party payer websites). Ability to research, analyze, and communicate payer trends to identify reimbursement and training issues. Professional communication with payers, vendors, and hospital contacts to promote contractual compliance; contribute to payer report cards in coordination with contracting and other revenue cycle departments. Participation in Denials Committee and capacity to conduct training for Billing and Follow-up staff as needed. Strong negotiation abilities to resolve difficult claims; tactful and diplomatic information sharing. Extensive contacts with patients, payers, physician office staff, coding staff, credentialing, case management, department heads, and department staff. Physical Demands
The physical requirements described here are representative of those that must be met to perform the essential functions of this job. Standing: Constant Walking: Frequent Sitting: Rare Lifting/Carrying: Frequently up to 50 lbs Pushing/Pulling: Frequently Climbing: Occasional Balancing: Occasional Stooping/Kneeling/Bending: Frequent Reaching/Overhead work: Frequent Grasping: Frequent Speaking: Occasional Hearing: Constant Repetitive motions: Constant Eye/Hand/Foot coordination: Frequent Benefits
Continuing Education 403B Retirement Plan with Employer Match Contributions Employee benefits including medical, dental, vision, life, disability, and related programs Tuition assistance, relocation assistance, paid time off, and other programs Employment details
Seniority level: Mid-Senior level Employment type: Full-time Job function: Accounting/Auditing and Finance Industries: Hospitals and Health Care Referrals increase your chances of interviewing at North Mississippi Health Services. Get notified about new Revenue Specialist jobs in Winfield, AL.
#J-18808-Ljbffr
The Revenue Cycle Specialist at North Mississippi Health Services is responsible for facilitating effective Revenue Cycle flow, including bill processing and resolution, denials and appeals management, and recurring reporting to monitor status and performance. This role reports to the Billing Manager and requires experience with third party payers and contracts, strong organizational, analytical, and communication skills to interface with payers, vendors, and staff in claims review, analysis, and resolution to promote payment capture and the financial health of the organization. Job Functions
Billing & Follow Up: Processes billing by receiving, interpreting, processing, and submitting through various edits to third party payors in electronic and hard copy formats. Billing follow up by contacting third party payers or accessing payer portals to determine payment expectations and resolve claim problems. Facilitates information exchange by interpreting payer and patient inquiries to expedite payment. Denial Management: Manages denial receivables to resolve accounts and develops strategy for appeal and follow-up. Analyses denials to determine reasons and identifies trends; reports significant and recurring issues with possible solutions to the Denials Management Supervisor and Billing Manager. Takes corrective action to reduce or eliminate payment issues through procedural improvements. Contract Management: Maintains familiarity with payer methodologies and communicates with NMHS staff; manages paid claims to resolve underpaid accounts; analyzes underpayments and identifies trends with possible solutions to the Denials and Underpayment Manager. Communication: Communicates professionally with third party carriers, vendors, and hospital contacts to promote contractual compliance. Liaison: Contacts insurance companies regarding denial, underpayments, or rejection issues; serves as liaison between payers and hospital departments/physician offices or patients to resolve denials and underpayment issues. Reporting: Assists in preparation of monthly denial and variance reports as requested. Regulation: Adheres to NMHS/NMMC policies, procedures, guidelines, and applicable local/state/federal regulations and laws. Qualifications
Education: Bachelor’s Degree in Business, coding, or equivalent field required. Associate’s or High School with equivalent revenue cycle experience may be considered in lieu of a degree. Licenses and Certifications: (as required by role) Work Experience: 1-3 years Knowledge, Skills, and Abilities
Excellent analytical and problem-solving skills; strong organizational and written/verbal communication skills. Interpersonal skills and computer proficiency (Microsoft Office, Outlook, third party payer websites). Ability to research, analyze, and communicate payer trends to identify reimbursement and training issues. Professional communication with payers, vendors, and hospital contacts to promote contractual compliance; contribute to payer report cards in coordination with contracting and other revenue cycle departments. Participation in Denials Committee and capacity to conduct training for Billing and Follow-up staff as needed. Strong negotiation abilities to resolve difficult claims; tactful and diplomatic information sharing. Extensive contacts with patients, payers, physician office staff, coding staff, credentialing, case management, department heads, and department staff. Physical Demands
The physical requirements described here are representative of those that must be met to perform the essential functions of this job. Standing: Constant Walking: Frequent Sitting: Rare Lifting/Carrying: Frequently up to 50 lbs Pushing/Pulling: Frequently Climbing: Occasional Balancing: Occasional Stooping/Kneeling/Bending: Frequent Reaching/Overhead work: Frequent Grasping: Frequent Speaking: Occasional Hearing: Constant Repetitive motions: Constant Eye/Hand/Foot coordination: Frequent Benefits
Continuing Education 403B Retirement Plan with Employer Match Contributions Employee benefits including medical, dental, vision, life, disability, and related programs Tuition assistance, relocation assistance, paid time off, and other programs Employment details
Seniority level: Mid-Senior level Employment type: Full-time Job function: Accounting/Auditing and Finance Industries: Hospitals and Health Care Referrals increase your chances of interviewing at North Mississippi Health Services. Get notified about new Revenue Specialist jobs in Winfield, AL.
#J-18808-Ljbffr