Revenue Cycle Specialist

At SCP Health, what you do matters As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care. Why you will love working here: Strong track record of providing excellent work/life balance. Comprehensive benefits package and competitive compensation. Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect. Primary Duties and Responsibilities: Responsible for tracking, reporting and trending chart and edit volume to ensure timely processing and workflow integrity Evaluate and ensure proper chart flow ensuring deadlines are met Monitor departmental inventory by process and report to management daily Communicate and follow up on volume not processed as deadlines approach Research complex edits escalated to the department and implementing resolutions that result in denial prevention and an increase in billing quality and revenue Outbound calls to insurance carriers for additional data gathering Examine KAV reports on a monthly basis Determine top denials Initiate resolution Report out for MOR Follow up and resolution to complex edit issues Frequent communication with offshore partners regarding deadlines and edit resolution Assist in meeting deadlines and target inventories by processing edits when needed Maintain a comprehensive knowledge of the departmental policies and procedures Knowledge, Skills, and Abilities: Detail oriented and organized Self-motivated; capable of compiling/tracking data to meet deadlines and goals Excellent interpersonal skills Ability to work equally well individually and in a team environment and adhere to our CORE values of Agility, Courage, Collaboration and Respect Professional attitude and demeanor Written and oral communication skills Proficient computer knowledge of Word, Excel, Windows and Outlook Quick learner with an aptitude for custom computer systems Previous success and comfort with entering data for extended time periods and limited interruptions EDUCATION (Required and/or Preferred): High school diploma or equivalent required FIELD OF STUDY (Preferred): Business or healthcare related field SUPERVISION EXERCISED: N/A QUALIFICATIONS: Previous Experience: One year experience in medical billing preferred One year experience in a fast-paced production environment Experience in Microsoft Excel, Word & Outlook Knowledge, Skills, and Abilities: Detail oriented, organized, self-motivated Capable of compiling/tracking data to meet deadlines and goals Excellent interpersonal skills Quick learner with an aptitude for custom computer systems Previous success and comfort with entering data for extended time periods and limited interruptions Certification and Licenses: N/A CONTACTS INSIDE AND OUTSIDE THE ORGANIZATION: Examples of the information needed: Daily contact with Department Leadership Frequent contact with offshore partners written and oral Frequent contact with insurance carriers and facilities via phone calls WORK ENVIRONMENT AND PHYSICAL DEMANDS: Hybrid work schedule (40 hours/week); ability to work well independently in a remote setting or in the office Courteous and professional interactions with co-workers and outside parties Occasional overtime may be required Continuous oral & written communication and listening skills High level of integrity, accuracy, honesty, loyalty, and trust Office noise and distractions must be minimized to promote quality and productive work Job requires a high level of mental awareness and concentration ability High level of independence; will usually work in solitude and will assume the responsibilities of prioritizing, and determining workload Ability to be flexible with duties and responsibilities PRIMARY LOCATION: Home Based or Lafayette, LA SECONDARY LOCATION(S): N/A CONFIDENTIALITY: The daily activities of this position will be held in the strictest confidence whether it is in regard to a person, individual and/or a strategic initiative. Confidentiality must be maintained on any and all documents and/or information processed. COMPLIANCE: All SCP Health employees will abide by all policies and procedures including the SCP Health Corporate Compliance Program and will adhere to all applicable local, state, and federal laws. DISCLAIMER: The above statements reflect the general duties considered necessary to describe the essential functions of the job as identified and shall not be considered as a detailed description of all work requirements which may be inherent in the position. They may be subject to change at any time due to reasonable accommodation or other reasons. #LI-PM1 Pay Range: 15.00 - 21.00 USD per hour This range represents the anticipated base salary for this role. Actual compensation will be determined based on experience, qualifications, and internal equity considerations. We offer a comprehensive benefits package designed to support your health, financial well-being, and work-life balance, including medical dental, vision insurance, a 401(k) plan with a company match, paid time off and holidays, professional development support, and employee wellness resources. Visit our website for further information. #J-18808-Ljbffr