Revenue Cycle Specialist

About this role

REMOTE IN WICHITA, KS
Hunter Health provides all-encompassing care for the Wichita community, including medical, dental, behavioral, vision, laboratory, radiology and pharmacy services, all in one place. We pride ourselves in providing the support patients need to take control of their health and their whole wellbeing. Our Hunter Health team is at the heart of our operations. From the initial interaction with a new patient to empowering individuals with the knowledge to manage their health - it begins with each member of our staff. Regardless of role or responsibility, every team member is a valuable part of living our mission and upholding our positive work environment with our Standards of Culture.
We exist to improve the health and wellbeing of everyone in our community.
Schedule: Monday - Friday, 40 hour week
Full Time Benefits:
20 days of PTO per year, plus 10 paid holidays.
Employer-paid Benefits include:

• Basic life insurance

• Short-term disability

• Long term disability

• Employee Assistance Program with 12 free sessions per year

Optional Benefits include:

• Medical

• Dental

• Vision

• Supplemental life insurance

• Accident and critical illness insurance

• Identity Theft Insurance

• 401k with Safe Harbor Plan match

Summary: The Revenue Cycle Specialist is responsible for working with insurance companies and patients to promote the growth of patient service revenue. The role involves reviewing medical, radiology, obstetrics, dental, and vision claims to ensure current and accurate patient account records and accounts receivable. The Revenue Cycle Specialist functions in accordance with established federal, state, and clinic standards, while complying with all federal grants and Hunter Health Clinic (HHC) policies and procedures.
Essential Functions:

• Provides accurate and timely submissions of claims according to payer rules and guidelines.

• Posts payments, slides, and adjustments to patient pay accounts accurately.

• Prepares and mails paper claims in a timely manner.

• Assists with reviewing and processing aging monthly claims.

• Communicates with patients, payers, attorneys, and program contacts regarding claims, billing concerns, collections, or financial transactions.

• Provides input to the Director of Revenue Cycle on benchmarks and progress on billing goals.

• Manages and monitors clearinghouse, payer portal rejections, and return-to-payer claims.

• Handles any rebills or resubmissions of claims, as necessary.

• Batches and posts payments and adjustments to patient accounts according to payer and departmental guidelines.

• Reviews remittance advice and denials from third-party payers to ensure accuracy.

• Assesses reports and ensures that all open claims have been resolved and billed accurately.

• Builds relationships with third-party payers, providers, and other representatives.

• Attends insurance training sessions and other meetings to stay abreast of current medical and dental billing rules and regulations.

• Travels when necessary to meet operational needs.

• Performs all other duties as assigned.

Qualifications:

• High school diploma or GED is required.

• 1-3 years of experience in medical and/or dental billing, health care administration, or a related field is preferred.

• Knowledge of Medicare, Medicaid, private payer, workers' compensation, and third-party liability rules for accurate billing is required, with knowledge of FQHC billing a plus.

• Current working knowledge of ICD-9 coding is required, and ICD-10 and DSM coding knowledge, along with CPT (Level 1 HCPCS), Level 2 HCPCS, and ADA codes, is

• Medical billing and/or medical coding certification is preferred.

Skills:

• Listens, identifies, and responds quickly and effectively to internal and external needs.

• Communicates effectively with all patients, providers and stakeholders.

• Displays organizational skills, abilities to multi-task, and uses time and resources effectively.

• Displays good judgment and decision-making skills.

• Effectively collaborates and seeks clarification and confirms accuracy as needed.

• Utilizes teamwork to achieve desired results and contributes to projects while developing positive working relationships.

• Pursues goals with commitment and takes initiative eagerly.

• Demonstrates accuracy, thoroughness, and reliability; manages time and priorities; develops and follows work procedures.

• Evaluates own performance and accepts constructive feedback to continue learning.

Physical and Mental Demands of the Job:
All employees, including those who become disabled, must be able to perform the essential job function listed below, either unaided or with the assistance of a reasonable accommodation. The functions listed below are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position. This essential functions document does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

• Talking: The ability to speak clearly and effectively.

• Average Hearing: The ability to hear average conversations and respond accordingly.

• Repetitive Motion: The ability to sit, stand, walk and use hands to handle, feel and reach.

• Finger Dexterity: The ability to use fingers to make small movements such as typing, picking up objects and pinching fingers together.

• Average Visual Abilities: The ability to focus on items clearly, including close vision, color vision and the ability to adjust focus.

• Working Conditions: The ability to work in a well-lit, climate-controlled environment, with a noise level that is occasionally high. There is potential exposure to infectious diseases.

• Physical Strength: The ability to occasionally lift and/or move…