Proliance is one of the largest surgical care centers in the country, providing excellent care at more than 100 centers throughout Washington State. Many of our surgeries are performed at our own ambulatory surgery centers—where costs are often lower and recovery times faster. Patients return home the day of their surgery to begin healing and rehabilitation and get back to doing what they love, faster. Each and every teammate has a crucial role as a part of our team focused on providing excellent patient care with high value for our patients, their families, employers, payors and our community.

What We Stand For:

At Proliance Surgeons, it is our mission to be the leader in physician-led healthcare services. Each teammate contributes to our vision of Exceptional Outcomes, Personally Delivered. Our values of Collaboration, Accountability, Respect, Equity and Stewardship transcend all of our relationships: our patients and their loved ones, one another as team members, our business associates and our community. Every teammate is expected to embrace and demonstrate these shared values.

Position Summary

The role of the Revenue Cycle specialist is a valued member of our Revenue Cycle team. As a Revenue Cycle Specialist, you will work in the office and be responsible for overseeing bill processes including Charge entry, Billing, Claims, Patient AR and Insurance AR. You will also post payments, handle credit resolutions, along with other revenue cycle functions.

Key Duties and Responsibilities

The key duties and responsibilities of the Revenue Cycle Specialist include, but are not limited to:

• Process self-pay check out patients
• Assist with surgery pre-collects
• Post workers comp form charges
• Legal A/R follow up
• Creating invoices
• Posting legal payments
• Posting OTC payments
• Processing Phreesia voids and refunds
• Assist CSO staff with data collection and questions
• Answering internal staff questions
• Answering phones
• Complete duties and assist others as directed
• Verify information for claims is correct prior to billing
• Review Surgical coding for accuracy prior to billing
• Process all Primary, Secondary, and tertiary claims and address any edits or rejections.
• Post all patient payments
• Must follow all policies as introduced during new teammate On-Boarding, updated real-time and outlined in Teammate Handbook

Education/Experience

• High School diploma or GED
• Minimum 1-2 years medical billing experience
• CPC or other equivalent certification
• Orthopedic Coding Experience a plus
• Experience with Nextgen and Amkai Billing Systems preferred

Knowledge, Skills and Abilities

• Strong revenue cycle background
• High level of independence, adaption, and accuracy
• Ability to navigate online Payor portals and websites
• Ability to effectively use Office equipment
• Basic knowledge of Microsoft Office Word and Outlook
• Superior customer service skills
• Great interpersonal skills; demonstrating patience, composure, and cooperation; working well with all patients, physicians, and staff
• Understanding of and adherence to all safety, risk management and precautionary procedures, including the consistent respect for confidentiality (HIPAA)
• Using time efficiently, with meticulous attention to detail, accuracy, and completion
• Ability to manage multiple factors for the best result
• Resourcefulness in addressing first level problems and tenacity to see things through to solution
• Ability to remove oneself personally from given situations, remaining objective
• Able to adapt to change, delays or unexpected events while maintaining a positive mindset
• Clear oral and written communication
• Ability to provide feedback to improve performance
• Self-motivated; able to work following specific guidelines and in accordance with detailed instructions; measure self against standard of excellence, overcome obstacles and challenges with little supervision

Work Environment/Physical Demands

The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions.

Work may be performed in an office and clinical environment. Requires corrected vision and hearing to normal range. While performing the duties of this job, the associate is regularly required to talk or hear. The associate is required to sit for long periods of time, stand and walk, bend and stretch. Use of telephone and computer is required. Manual dexterity required for use of computer keyboard. Occasionally lifts and carries items weighing up to 40 pounds. May requires working under stressful conditions or working irregular hours.

This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.