Revenue Cycle Specialist

Pay Grade: DOE

Department/Division: Administration

Classification: Non-Exempt

POSITION SUMMARY

The Revenue Cycle Specialist handles and resolves insurance billing, follow up and denial issues to ensure that practice receives correct reimbursement from the insurance companies. They will also research and answer all inquiries, regarding patient accounts. The goal is to resolve billing/denial issues through positive relationships/communication with the insurance companies, patients, and internal parties.

ESSENTIAL RESPONSIBILITIES

• Takes appropriate actions on denied charges to ensure claims are paid on the first follow-up call or appeal. • Works with assigned queues, aging and denial reports to accomplish the set goal for the position.
• Responsible for learning, understanding, and following payer guidelines.
• Notifying management of payer policy changes.
• Ensuring appropriate information is submitted to insurance companies to expedite payment.
• Completes appropriate adjustments and refund requests based on contract, modifiers, or appeal denials.
• Handle incoming calls for information request from insurance companies and patients.
• Works to understand the clinical documentation that dictate services billed.
• Reallocate misapplied payments and adjustments.
• Work special assignments when needed.
• Documents accounts correctly.
• Assure compliance with all company plans policies and procedures set forth by CCMC.
• Maintain confidentiality of patient and employee information.
• Audit accounts at month-end and review.
• Represent the business office with a high level of integrity and professionalism.
• Other tasks and responsibilities as requested.

The above is not intended to be an all-inclusive list of essential functions for the job described, but rather a general description of some of the responsibilities necessary to carry out the duties of this position.

QUALIFICATIONS

EDUCATION:

High School Diploma or Equivalent

EXPERIENCE:

At least five (5) years office experience, one (1) year previous medical experience in billing, accounts receivables, and patient customer service preferred. Working knowledge of Commercial, Medicare, and Patient balance-billing preferred.

REQUIREMENTS:

Team player who can collaborate and communicate well with all levels of staff, insurance companies, patients, and co-workers. Strong analytical, business and organization skills.

ADDITIONAL REQUIREMENTS

Upon date of Hire:

• Current Negative TB Test
• Ability to Pass a DHSS Criminal History Check and Drug Test
• Must be current in all immunizations

EQUAL EMPLOYMENT OPPORTUNITY

CCMC shall seek to insure and provide equal opportunity for all persons seeking employment without regard to race, age, color, religion, gender, marital status, sexual orientation, military status, national origin, disability, or any other characteristic as established by law.

Ready to be a part of a great team?

A career at Cordova Community Medical Center (CCMC) may be the opportunity you've been looking for.
CCMC employees benefit package includes the Alaska Public Employee Retirement System (PERS), Annual and Sick leave accrual, Group Health Insurance, Life Insurance and nine paid holidays.

Apply Today!

To apply for one of our open positions, you can contact our Human Resources Coordinator by phone at 907-424-8221 or email. 

Apply online or download a Printable Employment Application.