REVENUE CYCLE SUPPORT SPECIALIST

Job Description

Job Description

Looking for a mission-driven career?

Do not just touch people's lives; help them change their lives.

Working with the Ironton-Lawrence County Community Action Organization Team is more than just a job; it is a mission. The ILCAO is a role model community agency that positively impacts people's lives. If helping people in our community overcome significant obstacles, like losing their jobs or changing careers, finding excellent housing and award-winning healthcare, or even assisting children in getting the foundations of an outstanding education, sounds exciting, then we want to meet you. 

Our mission is to measurably improve the well-being of our community by providing opportunities for those in need. The ILCAO has over a dozen departments that provide services ranging from education and health care to large-scale economic development projects. Our departments provide services that touch every aspect of life, and our employees are mission-driven agents of change in Lawrence County. We believe we can each experience the positive change we want to see in our area.

It is a wonderful place to work!

At ILCAO, we consider our team members more than just employees; they are a highly valued part of our organization. We offer competitive pay and an extensive list of benefits to show our appreciation and the value we place on our team members. Here are a few: 

• Medical Insurance 
• Company paid single Dental and Vision coverage
• Paid holidays
• Personal days
• Vacation time
• Sick time
• 403b with company match

Key Responsibilities

• Support day-to-day revenue cycle activities under the direction of the Revenue Cycle Manager.

• Coordinate with the contracted billing vendor regarding claims, accounts receivable, denials, billing

issues, and collection activities.

• Monitor billing activities and identify issues that may negatively affect reimbursement or cash flow.

• Assist with the review and maintenance of billing processes, workflows, and system information.

• Assist with fee schedule updates and related practice management system maintenance.

• Identify opportunities to improve revenue cycle efficiency, accuracy, and financial performance.

• Maintain accurate and organized documentation related to revenue cycle activities.

Key Competencies

• Understanding of healthcare revenue cycle processes.

• Knowledge of claims submission, payment posting, accounts receivable, denials, and collections.

• Attention to detail and accuracy.

• Ability to identify operational issues and recommend solutions.

• Ability to prioritize multiple revenue cycle activities and meet deadlines.

ILCAO-J0118

Knowledge of FQHC billing practices and PPS methodology preferred.

Coordinate with the contracted billing vendor to monitor and resolve claim denials.

Review denial information and assist in identifying root causes and recurring denial trends.

Track denial resolution activities and follow up on outstanding issues.

Analyze denial trends and communicate opportunities for process improvement to the Revenue Cycle Manager.

Assist with accounts receivable monitoring and follow-up activities.

Review monthly bad debt reports and identify trends, concerns, and opportunities for improvement.

Support initiatives designed to reduce preventable denials and bad debt.

Key Competencies

Denial management and problem-solving.

Analytical thinking and trend identification.

Knowledge of payer requirements and reimbursement practices.

Ability to research claim issues and determine appropriate next steps.

Strong follow-through and accountability.

Ability to use data to identify revenue cycle improvement opportunities.

3. Payer Relations, ERA & EDI Support

Key Responsibilities

Contact insurance payers to facilitate the transition from paper remittances to Electronic Remittance

Advice (ERA).

Support Electronic Data Interchange (EDI) setup and troubleshooting activities.

Communicate with payers regarding billing, enrollment, remittance, and payment-related issues.

Maintain documentation related to payer communications and electronic transaction enrollment.

Monitor payer-related issues and escalate unresolved concerns appropriately.

Assist in identifying opportunities to improve electronic payment and remittance processes.

Key Competencies

Knowledge of Medicare, Medicaid, and commercial payer requirements.

Understanding of ERA, EDI, and electronic claims/payment processes.

Professional communication with payer representatives.

Strong documentation and follow-up skills.

Ability to navigate payer portals and electronic systems.

Ability to resolve issues through effective communication and problem-solving.