Revenue Cycle Specialist

Overview

This position provides analytical support to Analyst II-Customer Service, Customer Service Supervisor, Coordinator, Managers and Senior Management. It serves as a knowledgeable resource within the Customer Service Unit. This position interacts with internal and external customers to provide information in response to inquiries about patient services per departmental policy, and handles parent concerns. This position participates in special projects and will assist with departmental processes.

Responsibilities of this position include ensuring consistencies are followed between co-workers as well as able to provide valuable information on job qualities and efficiencies. This position aids in the training of new employees. Maintains working knowledge of reimbursement methodologies while maintaining a high level of integrity, respect and confidentiality for our patients, families and co-workers. This position also adheres to upholding Shared Values and Service Excellence of the Hospital.

At Children’s Mercy, we are committed to ensuring that everyone feels welcomed within our walls. A successful candidate for this position will join us as we strive to create a workplace that reflects the community we serve, as well as our core values of kindness, curiosity, inclusion, team and integrity.

Additionally, it’s important to us that we remain transparent with all potential job candidates. Because we value the safety of the patients and families we serve, as well as the Children’s Mercy staff, we want to let you know that the seasonal influenza vaccine is a condition of employment for all employees in our organization. New employees must be willing to be vaccinated if found non-immune to measles, mumps, rubella (MMR) and chicken pox (varicella) and/or without evidence of tetanus, diphtheria, acellular pertussis (Tdap) vaccination since 2005.

If you are selected for this position, you will be asked to supply your immunization records as proof of vaccination. If you and have any concerns about receiving these vaccines, medical and/or religious exemptions can be further discussed with Human Resources.

• May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans accurately and in a timely manner, meeting goals for work quality and productivity. Coordinates with other staff members and physician office staff as necessary to ensure correct processing.
• As assigned, reconciles, balances, and pursue account balances and payments, as well as denials. This may involve working with payor remittances, facility contracts, payor customer service, provider representatives, spreadsheets, and the company’s collection/self-pay policies to ensure maximum reimbursement.
• May be tasked with researching payments, denials, and/or accounts to identify short/over payments, contract discrepancies, incorrect financial classifications, and internal/external errors. Make denial appeals and corrections as necessary.
• Builds strong working relationships with assigned business units, hospital departments, or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and resolve problems.
• Responds to incoming calls and makes outbound calls as required to resolve billing, payment, and accounting issues, offering assistance and excellent customer service to patients, their families, providers, and other internal and external customers.
• Works as a member of the patient financial services team to achieve goals related to days and amounts of outstanding accounts, aiming to reduce Accounts Receivable balances.
• Uses systems to document information, provide statistical data, prepare issue lists, and communicate accurately with payors.
• Works independently under general supervision, following defined standards and procedures. Reports to the Supervisor or Manager. Utilizes critical thinking skills to solve problems and reconcile accounts promptly. External customers include all hospital patients, their families, and all third-party payers. Internal customers include facility…