Revenue Cycle Specialist - Onsite Position - Sandpoint

Revenue Cycle Specialist

Kaniksu Community Health is a non-profit, award winning Community Health Center that provides integrated, team-based healthcare in north Idaho.

Patients consider us their partner in healthcare, over the course of their life and the spectrum of their health needs. From prevention and wellness to medical, dental, and behavioral health. From pediatric to geriatrics, we believe that quality healthcare should be accessible, approachable and affordable for everyone. Regardless of how a patient can pay, or the severity of their concerns, we help find solutions. We provide access to comprehensive and integrated multi-disciplinary services through the Patient Centered Medical Home model of care.

But we're not just invested in our patients – we're invested in our people. We know that our overall success is a combined effort and we therefore strive to provide opportunities for our employees to learn, grow and thrive. We are proud to have built a positive and engaged team with a "family" spirit. Our team members are dedicated and provide a patient centric approach to care and know exactly what we are working on and why, and how their everyday work contributes to successfully achieving this goal.

The benefits of working for KCH include:

• Medical, Dental, Vision, and Life insurance
• Education Assistance and Guided Career Pathways
• 4% 401K employer match
• In-house medical, dental, or behavioral health services
• Year round, affordable on-site childcare at KCH Kid's Club

Are you passionate about supporting accessible, quality healthcare in your community?

We're seeking a Revenue Cycle Specialist to join our finance team. In this mission-driven role, you'll manage and optimize all phases of the revenue cycle—including billing, claims submission, denial management, and patient account follow-up. You'll work closely with both clinical and administrative teams to resolve issues, maximize reimbursement from patients and payers, and maintain compliance with healthcare regulations. Join us in advancing equitable care while ensuring our services remain available to those who need them most.

Key Responsibilities:

• Ensure accurate entry of patient demographics, insurance details, and treatment codes (CPT, ICD-10, HCPCS). Review patient accounts and clinical documentation to ensure accurate billing.
• Follow up on unpaid or denied claims; investigate and resolve denied or rejected claims, discrepancies or errors.
• Assist in the review of patient refunds and adjustments.
• Respond to patient and insurance inquiries related to billing, payment plans, and account status.
• Monitors insurance claims for timely reimbursement
• Ensure compliance with payer policies, HIPAA regulations, and internal billing procedures.
• Maintain current knowledge of insurance guidelines, coding practices (including CPT, ICD-10 and HCPCS codes), and compliance regulations including payer policies and HIPAA regulations.
• Collaborate with providers, coding staff, and front desk to resolve documentation or billing issues, and escalate any discrepancies and complex billing issues to Revenue Cycle Manager.
• Generate and analyze aging reports and accounts receivable reports to support cash flow goals. Provide reporting for Quality and VBC as needed.
• Reconcile accounts receivable and identify trends.
• Support month-end reconciliation and reporting as required.

Experience Needed to Land this Gig:

• High School Diploma or equivalent required.
• Certified Coding Specialist qualification or equivalent preferred.
• Minimum 2 years of experience in medical billing, coding or revenue cycle operations in a healthcare setting.
• Strong knowledge of medical terminology, insurance processes, insurance plans, billing codes (ICD-10, CPT, HCPCS) and reimbursement methodologies.
• Proficient in using medical billing software and electronic health records (EHR) systems (Athena and/or NextGen).
• Familiarity with Medicare, Medicaid, and commercial payer policies.
• Excellent organizational and time-management skills. High attention to detail and accuracy.
• Strong problem-solving and analytical abilities.
• Clear and professional communication with patients and colleagues.

Work Schedule:

Full Time

No. of Hours/week - 40

Monday to Thursday

Candidates must be authorized to work in the United States without current or future employer sponsorship. Relocation assistance is not available for this position.