Revenue Cycle Specialist

Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Position: Revenue Cycle Specialist - Family Medicine & Community Health

Entity: Clinical Practices of University of Pennsylvania

Department: Family Practice OutPt EA

Location: Penn Presbyterian Medical Center- 51 N 39th St

Hours: Full Time

Summary:

The Revenue Cycle Specialist (RCS) provides billing knowledge, expertise and oversight in support of the department's effort to effectively manage its revenue cycle and ensure expedient claims processing and payment for services. Reporting to the Revenue Cycle Manager, the position performs a variety of functions including working the department work queues, resolving edits, rejections and department specific billing inquiries. The RCS will troubleshoot issues identified related revenue cycle workflows and provide data analytics as necessary.

Responsibilities:

• Monitor department work queues to ensure account resolution within established benchmarks and escalate issues to the Manager as appropriate.
• Complete charge entry responsibilities, process charge correction files, and append required data to ensure accurate and timely billing.
• Utilize critical thinking and analytical skills to identify, analyze, and report front-, middle-, and back-end revenue cycle issues and performance trends. 
• Analyze reimbursement trends by site, provider, and program to support operational decision-making, clinical utilization, and revenue optimization. 
• Report, investigate, and assist in resolving coding, billing, and A/R issues identified through continuous monitoring of reports and work queues. 
• Serve as a departmental resource for reporting and analyzing reimbursement related to clinical activities, including both professional and hospital components. 
• Meet regularly with the Manager to review the status of work queues, accounts receivable, special projects, and problematic or unusual accounts. 
• Participates in Entity and Department wide initiatives aimed at achieving targeted performance metrics. 
• Works effectively to meet project and assignment deadlines. 
• Assists in orienting new employees, if/as needed Attend staff meetings and continuing education or in-service training sessions as directed by the Manager. 
  
  
• Maintain confidentiality regarding medical records and corporate documents in accordance with HIPAA, Joint Commission, and organizational requirements.

Education & Experience:

• H.S. Diploma/GED AND 4+ years experience in a healthcare revenue cycle (Required).
• Associate of Arts or Science or Bachelor of Arts or Science AND 1+ years healthcare revenue cycle (Preferred).

Skills & Abilities:

• Experience with Epic or another Electronic Medical Records application (Preferred).
• Demonstrates analytical skills (Required).
• Ability to adapt to change and handle multiple tasks in a complex environment (Required).
• Work independently and as a team player (Required).
• COMMUNICATION: Ability to work effectively with a range of business, clinical, and academic leaders (Required).
• COMMUNICATION: Demonstrates interpersonal/verbal communication skills (Required).
• FINANCE: Experience with reimbursement models, payer contracting, commercial product models, and payment reform/strategies (Preferred).
• TECHNOLOGY: Ability to use Microsoft Excel (including Pivot Tables), Word, and Outlook (Required).

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.