Revenue Cycle Specialist

Summary of Duties

Monitors the revenue cycle production of the facility Business Office Managers. Assists with promoting effective practices to minimize Private Accounts Receivable. Works to implement streamlined processes, increase collections, and reduce bad debt write-offs. Assists all revenue cycle stakeholders in gaining the maximum appropriate reimbursement.

Essential Job Functions

1. Provides initial training and continuing education of facility Business Office Managers. 2. Serves as liaison between facilities, CBO, and external parties contracted for Alabama Medicaid expertise. 3. Serves as the Business Office Manager’s primary resource for information related to registration requirements, insurance verification and authorization, financial form completion, billing requirements, general documentation, and coordination of benefits and subrogation, among others. 4. Assists facility Business Office Managers in submitting paperwork to qualify residents for Medicaid eligibility. 5. Compiles information and executes on-site business office audits. 6. Monitors residents in Medicaid Pending status and assists the facility Business Office Managers with technical issues during this process. 7. Seeks to increase Medicaid offset awards and reduce bad debt write-offs related to Medicaid coverage gaps. 8. Monitors residents with active Medicaid coverage to prevent coverage drops related to delayed annual reviews or excess resources. 9. Trains and assists facility personnel in third party programs to gain reimbursement. 10. Documents all training and education. 11. Assists with third party payor contracting as needed. 12. Provides emergency backup coverage for facility Business Office Managers during extended absences. 13. Troubleshoots the Senior Living billing system issues impeding revenue cycle functions. 14. Maintains the end user access and functionality in the Medicaid web portal, Medicaid admission system, and the resident fund management system. 15. Prompts the Business Office Managers and external parties to swift execution of month end requirements to ensure closing deadlines are met or exceeded. 16. Performs other job related tasks as assigned.

Education

High school diploma or equivalent required. Associated degree preferred but not required.

Experience

Minimum of four (4) years of related experience in healthcare accounts receivable billing and collections. Minimum of two (2) year of experience in Skilling Nursing Facility billing and reimbursement required; three (3) years preferred.