Job Description:

Spectrum Health Service, Inc. - a world-class community health center that proudly cares, values, and serves its community is in search of a dynamic Dentist dedicated to world-class healthcare service delivery. If this is you, come work your life's passion at Spectrum and earn your living where your heart is! Nationally recognized as a Level-3 Patient-Centered Medical Home, the highest designation for health centers, Spectrum Community Health Center provides the highest level of care improving the health conditions and advancing health equity within our communities through the delivery of quality primary care, specialty, and social services. We are the leading provider of world-class healthcare in our communities providing quality, safe, and effective care in an efficient, equitable, and timely fashion. We serve as a model of success for the other Federally Quality Health Center.

Job Summary:

The Revenue Cycle Specialist will work as an integral part of an interdisciplinary team to support the goals and protocols of the revenue cycle workflow. Responsible for Charge Entry processing, Account Receivable follow-up, and other revenue cycle related functions.

Analyzes, troubleshoots, and measures performance for the processes affecting the revenue cycle. Works in partnership with the Revenue Cycle Manager and Revenue Cycle Director to ensure optimal system configuration is maintained. Determines opportunities for improvement. Facilitates process improvement to affect change to achieve revenue cycle best practices. Ensure consistency and compliance throughout the Network.

Essential Functions:

• Collaborate with Revenue Cycle Manager (RCM) in the planning, implementation, administration, and evaluation of projects that have the potential to increase access revenue, improve service, or results in cost reduction.
• Communicates with personnel in all areas of Spectrum including attending departmental meetings.
• Attend all insurance provider representative meetings as well as lead provider meetings when RCM is not present or available.
• Strong customer service skills; answering client, patient and carrier calls; prompt return and follow up to all interactions; prompt response to requests for information.
• Timely management of charge entry and accounts receivable as assigned, using the Athena Workflow Dashboard, Claims Worklist, Self-Pay Worklist, Patient Refund Worklist and Accounts Receivable Aging Wizard.
• Effectively handle complex payer denials and front-end rejections.
• Liaison with patients and insurance companies to address and correct coordination of benefits or demographic related issues.
• Responsible for ensuring secondary claims are properly formatted, submitted, and followed up on in a timely manner.
• Expertly add specific data such as modifiers, payer specific information, including authorization criteria, POS codes, CPT and ICD-10 codes and encounter codes.