Revenue Cycle Research Specialist- Medicaid SSI- Hybrid

This job is primarily responsible for assisting patients and the health system in all aspects related to accounts receivable management and financial reporting by analyzing data and performing research related to all functions. Responsibilities include, but are not limited to, handling patient billing questions, complaints, and inquiries with the highest degree of courtesy and professionalism; offering alternative solutions and explaining financial impacts; communicating, reconciling, adjusting and collecting receivables from the customers; researching deferred patient inquiries and legal requests for resolution of inquiries; and communicating and keeping record of all resolved and unresolved issues with the leadership department and departmental leadership team. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties. Education Required – High school diploma or equivalent Preferred – Bachelors’ degree Work Experience Required – 4 years’ of direct healthcare experience; OR additional education can be substituted for experience Knowledge Skills and Abilities (KSAs) Must have computer skills and dexterity required for data entry and retrieval of patient information. Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout required job processes. Must be proficient with Windows-style applications, keyboard, and various software packages specific to role. Strong interpersonal skills. Working knowledge of medical terminology utilized in medical billing including Current Procedural Terminology (CPT) and International Classification of Diseases Codes (ICD-10 and ICD-9) code. Working knowledge of record keeping using an automated system and/ or health care billing including Medicaid, Medicare, or other third party payers. Working knowledge of public and private sources of assistance and methods of qualifying for funding. Working knowledge of collection laws, regulations and techniques; current office practices and procedures. Job Duties Researches and resolves complicated patient billing inquiries that require in depth research and responds in a timely manner. Researches and responds to all inquiries within SOP/KPI guidelines. Serves as a liaison between the patients, providers of health care services, external departments, or other responsible parties to perform account and chart reviews, ensure charges are recorded accurately, overturns insurance denials, provides benefit explanation, processes financial assistance application, and resolves all issues in accordance with established guidelines. Provides routine support with on-going staff training/coaching. Assists leadership with special projects developed around educating staff members via staff meetings, improving patient satisfaction, developing new departmental procedures, and developing new training material. Reviews policies, procedures and practices for compliance with established legal standards and state guidelines. Ensures that all work complies with standard departmental policies and procedures. Provides top quality customer service experiences on every patient inquiry received to ensure and maintain high levels of patient satisfaction. Provides back up support to other areas during peak times in accordance with department standards. Other job duties as assigned. Physical and Environmental Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Sedentary Work - Exerting up to 10 pounds of force occasionally (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met. Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid. The incumbent has no occupational risk for exposure to communicable diseases. Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, or other compliance-related concerns. Equal Opportunity Employer Statement The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status. Ochsner is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any legally protected class, including protected veterans and individuals with disabilities. #J-18808-Ljbffr Ochsner Health