Revenue Cycle Specialis

Position Summary

This position is responsible for managing billing, collections, and revenue processes to ensure timely and accurate reimbursement for services provided.

Essential Job Functions

The employee must have the ability to:

• Managing all aspects of the revenue cycle, from claim submission and insurance verifications to collections and reconciliation.

• Perform data entry from source documents into the Electronic Health Record for client services being billed or otherwise reported to commercial third party, contract, State of Washington and King County payors.

• Reviewing and submitting claims accurately, ensuring compliance with payer requirements and coding standards.

• Tracking and following up on unpaid claims, working with payers to resolve denials and rejections in a timely manner.

• Preparing and submitting appeal letters for denied claims, ensuring that all required documentation is included in a timely manner.

• Process incoming mail concerning billing and client statements.

• Post payments to client accounts, perform account research and process daily deposits

• Create scanned copies of all checks, complete deposit slips and perform bank deposits.

• Maintain accurate records of all communications with clients regarding their accounts, including payment agreements, and follow-up actions.

• Address customer inquiries and complaints related to billing and collections, ensuring a professional and courteous approach.

• Prepare monthly reports on the status of self-pay overdue accounts and collection efforts to management for collection list approval.

• Assist in training clinical staff in procedures required to maximize reimbursement.

• Maintain knowledge of contract data submission requirements.

• Serve as a liaison between Agency and Contract agencies to maintain requirements.

• Maintain strict confidentiality and security about clinical and financial information.

• Practice and incorporate Quality Improvement principles in daily work activities.

Essential Job Functions

• Provide back-up support to others in the department, prepare reports and perform other general administrative duties.

• Maintain required levels of productivity and performance standards.

• Meet all required work deadlines.

• Ensure that supervising manager receives proper and timely information that is relevant to VCCC business.

• Ensure compliance with all state and federal regulations including HIPAA.

• Attend required in-service training and committee meetings as requested.

• Perform other related duties as assigned.

Minimum Qualifications

Education:

• Associate’s degree or three years of relevant experience.

Experience:

• Non-Profit Behavioral Health insurance outpatient and inpatient billing

• Proficient computer skills, with knowledge of Microsoft Word, Outlook, and Excel.

Other:

• Pass required background checks.

• Excellent verbal and written communication skills.

• Ability to work in a team environment.

• Ability to meet deadlines, work under pressure and with frequent interruptions.

• Ability to apply common-sense understanding and logic in day-to-day activities.

Interpersonal Attributes:

• Excellent communication skills, teamwork, and attitude.

• Multicultural awareness.

Intrapersonal Attributes:

• Ability to adapt.

• Accepts accountability

• Empathetic.

• Reliable

• Self-disciplined.

• Stress management.

• Strong work ethic.

Working Conditions

Work is performed inside and outside in varying temperatures. Employee may occasionally be required to push or lift up to 25 pounds. May be exposed to office supply odors or vapors. Employee is sitting, most of the time. Employee is also required to stand, walk, type, bend, write, read, interpret, and explain complex issues and speak on the telephone