Rev Cycle Specialist II | Provider Enrollment

Revenue Cycle Specialist II Provider Enrollment

Location: Columbia County Health System Dayton, WA Work Arrangement: Onsite Preferred | Open to Remote Schedule: Full-Time | 40 Hours per Week Compensation: $26.00 - $30.00 Flexible Schedule: Monday - Friday | Operating Hours 8:00am - 5:00pm Pacific Time

Join our team at Columbia County Health System!

Our Revenue Cycle team is dedicated to ensuring everything goes right for the patient. We are looking for a dependable, detail-oriented Revenue Cycle Specialist II who has a strong ability to work independently, brings a positive outlook to their work, and is willing to actively contribute to the success of the team.

This position serves as an important resource for our patients, providers, Revenue Cycle team, and the organization. The ideal candidate will bring experience in medical billing and/or provider enrollment, strong critical-thinking skills, excellent attention to detail, and the ability to effectively navigate payer requirements and enrollment processes.

Onsite work at Columbia County Health System is preferred; however, we are open to considering qualified remote candidates.

What You'll Do: Revenue Cycle Specialist II Provider Enrollment, you will support both revenue cycle operations and provider enrollment functions, including:

• Utilize billing processes and best practices to help maximize reimbursement for services.
• Perform reconciliation of patient balances and diligently follow up on outstanding claims and accounts receivable.
• Review reports and account activity to proactively identify potential billing or reimbursement issues.
• Complete appeals and reconsiderations for claims as needed.
• Assist patients with questions and resolution of billing concerns.
• Identify trends and opportunities to improve Revenue Cycle processes.
• Initiate and process provider enrollment applications with commercial and government payers.
• Verify provider credentials, licenses, certifications, and other information required for payer participation.
• Maintain accurate provider information within payer enrollment systems and databases.
• Communicate directly with insurance companies regarding enrollment applications, outstanding requirements, and application status.
• Coordinate provider re-enrollment and revalidation to ensure participation information remains current.
• Serve as a resource for providers completing enrollment documentation and navigating payer requirements.
• Investigate and resolve claim denials or submission issues related to provider enrollment.
• Ensure enrollment activities are completed in accordance with applicable healthcare regulations and requirements, including HIPAA and CMS guidelines.
• Work collaboratively with the Medical Staff Services Manager and other organizational departments.
• Utilize provider enrollment systems such as CAQH, PECOS, and other payer-specific platforms.
• Maintain professional, responsive communication with patients, providers, payers, coworkers, and organizational leadership.
• Participate in team meetings, trainings, and other department activities.

What We're Looking For

• 3 years of medical billing experience preferred, with hospital billing experience preferred.
• Minimum of 6 months of credentialing or payor/provider enrollment experience.
• Understanding of ICD-10 and CPT coding preferred.
• Experience working with provider enrollment systems such as CAQH and PECOS preferred.
• Strong organizational skills and exceptional attention to detail.
• Ability to communicate effectively with a wide variety of internal and external stakeholders.
• Strong critical-thinking and problem-solving skills, particularly when addressing practical and time-sensitive issues.
• Ability to work independently with minimal supervision while also contributing as a collaborative member of the Revenue Cycle team.
• Consistent professionalism in communication, presentation, and demeanor.
• Ability to understand and apply applicable industry standards, regulations, and laws.

Preferred Certification: An accredited national certification through Healthcare Information Management, Revenue Cycle, or Medical Coding is preferred.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.