Revenue Cycle Collections Specialist

Revenue Cycle Collections Specialist

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.

As a Revenue Cycle Collections Specialist, you will provide crucial financial support and professional assistance, facilitating account resolution and contributing to the fiscal health of the organization. Every day you will expertly communicate with clients to resolve outstanding balances, meticulously document interactions, negotiate payment arrangements, and diligently follow established protocols to ensure timely and effective collection efforts. To be successful, you will demonstrate outstanding communication skills, strong negotiation abilities, and a persistent, empathetic demeanor, contributing to positive client relationships and efficient revenue recovery.

• Maintains quality and productivity at a rate established by PE RCM leadership for the fiscal year goal.
• Performs follow up on any outstanding accounts, prioritizing high dollar and aging accounts, and documents actions taken to resolve the claim in the practice management system (PMS).
• Understands payer guidelines regarding reconsiderations, corrected claims and appeals and works denials accordingly to maintain consistent cash flow.
• Works correspondence and/or medical record requests in a timely manner in accordance with payer deadlines.
• Demonstrates knowledge and use of the Practice Management System (PMS), Electronic Medical Records system (EMR), and all other related facility and payer portals/websites. Displays competency in the use of departmental equipment; e.g., telephones, computers, facsimile, printers, timekeeping systems, etc.
• Performs assignments independently, consistently prioritizes workloads, identifies denial trends and shares them with leadership.
• Follows the department chain of command: supervisors, manager, director. Utilizes leads for basic questions regarding workflow, payer questions, etc.
• Maintains current knowledge of billing including: CMS-1500, HIPAA, 837 Transactions, etc.
• Maintains attendance according to the departmental policies and attends PE RCM department/unit meetings.

Minimum:

• High School Diploma or GED
• Three (3) years physician-billing/collection experience or other related healthcare provider claims experience in a high volume medical healthcare claim environment. (Includes health plan physician claims/reimbursement/appeals experience)
• AHCCCS/ Medicare/government Commercial payer experience
• CMS -1500 and 837P billing experience
• Experience with EMR and Practice Management Systems, including Google
• Knowledge of insurance plan intricacies
• Current knowledge of CPT/HCPCS/ICD-10 codes
• Typing speed of 65 wpm and 225 kpm (10 key)
• Knowledge of collection guidelines and regulations
• Excellent problem solving and communication skills
• Ability to effectively interact with internal and external customers
• Ability to prioritize tasks and read and interpret complex contract language
• Effective verbal and written communication skills
• Proficient in the use of office equipment; e.g., telephone system, computer, fax machine, copier, printer

Preferred:

• Professional Biller Certification through AAPC
• Two (2) relevant college education
• Bilingual in Spanish

Hello Humankindness

Where Your Passion Meets Purpose: Join Dignity Health Medical Group

Are you a healthcare professional who believes that every patient deserves not just treatment, but unwavering compassion? Do you envision a world where healthcare isn't just a service, but a fundamental right, delivered with integrity and innovation? If so, then Dignity Health Medical Group (DHMG) is where your career finds its true calling.

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