Revenue Cycle Specialist - Remote; see eligible states

Position: Revenue Cycle Specialist - Remote (see full posting for eligible states)

NAH reserves the right to make hiring decisions based on applicants' state of residence if outside the state of Arizona. NAH currently hires for remote positions in the following states:

• Alabama
• Arizona
• Florida
• Georgia
• Idaho
• Indiana
• Kansas
• Michigan
• Missouri
• North Carolina
• Ohio
• Oklahoma
• Pennsylvania
• South Carolina
• Tennessee
• Texas
• Virginia

The Revenue Cycle Specialist is responsible for implementation and management of all revenue cycle operations and policies to ensure optimal and timely claims submission, denial prevention and resolution, cash flow and Accounts Receivable over 90. The Specialist monitors various accounts receivable reports and tools. The Specialist will have proven ability to manage Revenue Cycle EMR and Billing systems and process work with third-party payers and other entities to effectively resolve outstanding AR balances, including but not limited to: payer contract coding and fee schedule maintenances, payer credentialing/enrollment, authorization management, denial resolution and prevention and patient inquiries.

Accounts Receivable

* Maintain accounts receivable at expected standards set by department management.

* Maintain cash flow at expected standards set by department management.

* Meet productivity standards set by department management.

* Monitor days in A/R by reviewing monthly reports provided by management and proactively take measures to keep those days within standards set by management.

Billing

* Researches and resolves rejected, incorrectly paid and denied claims within an established time frame set by management.

* Educates clinic staff regarding changes to insurance and regulatory requirements.

* Understands and interprets insurance Explanations of Benefits (EOBs).

* Works with patients and colleagues to meet customer service expectations set by management.

* Ensures documents on patient accounts are kept up in a timely manner.

* Responds to all billing-related inquiries from patients, staff, and payers in a timely manner.

* Works with management and other staff to improve processes within the department and company.

* Identifies and reports payer issues to management with regard to denial trends or changes in payments.

* Processes refunds according to the payer's contractual terms and established federal and state regulations.

* Identifies claim denial trends by the payer and reports to management and team members regarding these trends.

Compliance/Safety

* Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.

* Stays current and complies with state and federal regulations/statutes and company policies that impact the employee's area of responsibility.

* If required for the position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.

* Completes all company mandatory modules and required job-specific training in the specified time frame.

Education

High School Diploma or GED
- Required

Experience

Minimum two (2) years experience with collection activity and reduction in accounts receivable in a healthcare setting
- Required
Minimum two (2) years experience in either a medical business office setting or hospital
- Required
Previous experience with 3rd party and managed care payer billing requirements, registration, verification of insurance or centralized computer systems
- Required

Experience with AHCCCS, Medicare and Commercial billing laws and regulations
- Preferred

Experience with a multi-hospital and employed physician practice environment
- Preferred

Healthcare is a rapidly changing environment and technology is integrated into almost all aspects of patient care. Computers and other electronic devices are utilized across the organization and throughout each department. Colleagues must have an understanding of computers, and competence in using computers and basic software programs.