Per Diem- - Revenue Cycle Specialist

Get to know Summit Pacific Medical Center: Your trusted partner in Health and Wellness, Summit Pacific is a vibrant and expanding public hospital district that operates a Critical Access Hospital with a Level IV trauma designation, three rural healthcare clinics, and a seven-day-a-week urgent care clinic. Our vision is “Through Summit Care, we will build the healthiest community in the Nation.” Our hospital is unique due to its size and accessibility. We pride ourselves on our ability to give patients quick access to a provider. Critical Access Hospital 24/7 Emergency Department Level II Cardiac Center Level III Stroke Center Level IV Trauma Care To learn more about Summit Pacific, visit Pay Range (depending on experience): $28.06 - $41.39 . Job Summary The Revenue Cycle Specialist is responsible for supporting the integrity and system framework supporting Revenue Cycle. Partners closely with the Billing, and Health Information Management/Coding teams, and department leaders to ensure compliance in claims administration. Develops reporting, dashboards and KPIs, providing seamless, accurate measurements used to enhance operational performance across Summit. Assists in the education of our patients regarding health insurance including explaining services covered by specific plans, as well as assisting the enrollment process in Washington Apple Health (Medicaid and Qualified Health Plans. Job Specific Duties and Responsibilities Provides direct support to the revenue cycle department to ensure revenue capture integrity. Researches, plans, and implements revenue cycle projects to maximize the cash flow/revenue returns to the medical center. Assists in managing workflows and processes to support revenue, patient throughput, patient experience, and regulatory requirements. Performs moderately complex data queries, mapping and analysis functions to ensure efficient and optimal utilization of Epic revenue cycle modules. Performs audits of accounts and productivity reporting to ensure department operational procedures are being implemented. Designs and develops data extractions, analysis, and reporting tools/dashboards for operations, to ensure financial objectives of value-based care contracts are met. Maintains an accurate Chargemaster, while identifying problems with charge capture and implementing reliable solutions for improvement; continually identifying opportunities to automate processes and improve revenue capture. Acts as a resource for internal and external customers and delivers exceptional service. Participates in process improvements and problem solving; researches and analyzes alternatives for improving work flows. Develops “best practice” recommendations. Maintains the insurance and provider NPI master files integrity and makes any necessary updates and/or changes. Responds to patient inquiries and requests. Ensures the patient’s comfort, dignity, safety and confidentiality at all times. Works as a liaison between our billing office, revenue cycle and all other departments. Ensures resolution of claims; develops internal processes improvements to ensure timely submission of claims. Supports enrollment, charity care, and other discount application processes. Actively assists patients and community members with enrollment in Washington Apple Health (Medicaid) and/or Qualified Health Plans. Processes admissions, performs verification of benefits/authorization, notification to the payor; including clinical information sent to payor as needed to obtain authorization for admission. The analysis includes, but not limited to review of patient’s demographics, payor data review, understanding payor methodology, commercial vs. government payor structures. Working knowledge of and understanding of diagnosis and patient’s prognosis, reviewing medical records as necessary to determine clinical information needed for payor. Performs other duties and special projects as assigned. *Essential Job Function Staff Member Responsibilities *Adapts to changes in the work environment: Asks clarifying questions and/or provides constructive input in a helpful and respectful manner. *Builds and maintains working relationships: Maintains effective working relationships with supervisor and direct co-workers. *Creates positive experiences for patients, customers and, co-workers: Consistently provides a level of service that meets SPMC standards. *Demonstrates ongoing learning & development: Participates in ongoing skills training and competency development. *Exhibits effective work skills: Successfully performs job duties in accordance with SPMC expectations for quality/accuracy, quantity, and timeliness. Re-priorities and/or shifts focus as needed to deliver expected results. *Facilitates Teamwork: Actively engages in team activities. Welcomes and supports new team members; promotes a positive work environment. *Fosters an environment of trust: Treats others with courtesy and respect. Does not engage in gossip or triangulation. *Supports SPMC mission, vision, and values: Develops awareness of departmental contribution to mission, vision and strategy. Participates in department strategies and tactics. Organizational Responsibilities In addition to the duties and responsibilities listed above, all employees are expected to adhere to Summit Pacific behavior and patient experience standards, comply with policies, procedures, and regulatory guidelines; and act in an ethical, professional, respectful, and collaborative manner. Required Education and Experience Graduate of an accredited school with a minimum of an associate degree. Bachelor’s degree in Math, Statistics, Biostatistics, Public Health, Finance, Accounting or closely related field is preferred. Three (3) years of healthcare revenue cycle, data analysis and reporting experience preferred. Required Licenses, Certifications and/or Registrations Washington Health Benefit Exchange In-Person Assister Certification is required at the time of hire and/or within 90 days of accepting the position. Required Knowledge, Skills, Abilities Comprehensive knowledge of the patient access/registration, coding, chargemaster, charging and billing work environments, workflows, and tasks. Knowledge of medical terminology. Intermediate to advanced skills in statistical modeling, data mining, analysis, and reporting. Knowledge of financial and benchmarking standards and related best practices. Proficient in the use of current technology, including Microsoft Office products. Ability to learn and effectively use electronic medical records and other systems and equipment. Ability to develop and maintain proficiency with insurance verification processes via multiple online and telephone insurance registry systems. Strong problem-solving and organization skills; ability to effectively prioritize work. Professional and effective written and verbal communication skills. Ability to identify and employ communication strategies appropriate to the audience. Strong mathematics skills and knowledge of payment processing functions. Ability to work collaboratively and effectively with multiple demands and sort time frames. Ability to work independently performing a wide variety of assignments that require the use of independent judgment, problem-solving, organization, and prioritization skills. FTE: 0 Work Shift: All non union, non exempt staff Working Location: Elma, Washington Benefits: Our uniquely designed benefits are here to support you and your family in staying well, growing professionally and achieving financial security! We take care of you, so you can focus on delivering our mission of caring for everyone, especially the most vulnerable in our communities. Benefits offered by SPMC: Competitive Compensation Medical Prescription Dental (including Orthodontia) Vision Healthcare FSA and daycare FSA Daycare subsidized benefit Life Insurance Accidental Death and Dismemberment (AD&D) Short- and long-term disability Generous employer 403b match contributions for retirement 457 retirement account for additional funds Employee Assistance Program (EAP) Tuition reimbursement Smoking Cessation Assistance Employee Wellness Program Employee Committees to participate in such as Spirit Team Beautiful on-site gym for employees Instructor led fitness classes for employees, including Yoga, Kettlebells and Bootcamps Walking trails on site Additional Information: Summit Pacific is a vibrant and expanding nonprofit public hospital district serving east Grays Harbor County, Washington. Founded in 1982, Summit Pacific now operates three locations comprised of a critical access hospital, primary care clinics, an urgent care clinic and range of ancillary and specialty services. Far enough to have privacy and enjoy the small-town lifestyle, yet close enough to have the benefits of the city. There are many year-round recreational activities in and around Grays Harbor such as: Hiking/ walking trails – whether you’re looking for short easy walking trails or long hikes you can find many trails located either on site or just miles from Summit Pacific. There are many great hiking trails about an hour away at the Quinault Rainforest which is also the home of some of the largest trees in the world! Kayaking – There are many areas that are easily accessible and have beautiful views. Nature viewing – Multiple whale watching towers and tours, state parks, Olympic Game Farm (where you can feed the animals straight from your car) Fishing & Hunting – If you’re looking for areas to hunt/ fish or looking for guided tours this is a great area! Westport is just 42 miles away with many opportunities to catch or buy fresh fish off the docks! Other activities – Multiple museums, winery, arcades, rentable mopeds, Seabrook (vacation beach town), many areas to surf for experienced surfers and surfing lessons for those who want to learn. Nearby colleges – Grays Harbor College is a community college located in Aberdeen with other community colleges located in surrounding areas, as well as some state colleges and universities in other areas of WA state. Summit Pacific Medical Center is an equal opportunity provider and employer that is committed to a policy of non-discrimination on the basis of race, sex, age, religion, color, national origin, ancestry, disability, marital status, arrest and court record, sexual orientation, and status as a covered veteran. This policy covers admission and access to, and participation in, treatment and employment in the hospital’s programs, activities, services, and employment. This organization participates in E-Verify. E-Verify is a service that verifies authorization to work in the U.S. through the U.S. Department of Homeland Security (DHS) and the U.S. Department of Social Security (SSA). For further information on E-Verify contact DHS at View phone number on click.appcast.io. Get to know Summit Pacific Medical Center: Your trusted partner in Health and Wellness, Summit Pacific is a vibrant and expanding public hospital district that operates a Critical Access Hospital with a Level IV trauma designation, three rural healthcare clinics, and a seven-day-a-week urgent care clinic. Our vision is “Through Summit Care, we will build the healthiest community in the Nation.” Our hospital is unique due to its size and accessibility. We pride ourselves on our ability to give patients quick access to a provider. Critical Access Hospital 24/7 Emergency Department Level II Cardiac Center Level III Stroke Center Level IV Trauma Care To learn more about Summit Pacific, visit Not finding the right fit? Let us know you're interested in a future opportunity by clicking Get Started below or create an account by clicking 'Sign In' at the top of the page to set up email alerts as new job postings become available that meet your interest!