Revenue Cycle Technician

Revenue Cycle Technician

Department:
Finance

Program:
Revenue Cycle

Reports To:

Revenue Cycle Manager

Employment Status:
Full Time

FLSA Status:
Non-Exempt

Schedule:

40 hours/52 weeks

Preference: TERO Ordinance 2017-01, P.L. 93-638

The Revenue Cycle Technician will be cross‑trained to perform a variety of duties. Responsibilities include understanding payer requirements; identifying payer issues accurately and developing a plan to resolve them; following up on outstanding balances and taking necessary action to ensure timely resolution; reading and understanding an "Explanation of Benefits" (EOB), identifying trends in billing, and addressing concerns to expedite payment; handling denials, credit balances, missing payments, payer recoupments, and unposted cash as it pertains to billing account follow‑up.

• Verification of appropriate Current Procedural Terminology (CPTs) and modifiers
• Ensure the coordination of claim activities on various insurance portals and via phone to check claim status and resolve claim issues
• Verify insurance payment is in alignment with payer contract by reviewing the contract status log and EOB received
• Research and resolve insurance denials
• Identify reason for claim rejections and complete proper action to ensure timely billing
• Support leadership with daily, weekly, monthly reporting needs as required and maintain third‑party logs
• Identify, research and resolve credit balances, missing payments, payer recoupments, and unposted cash as it pertains to billing account follow‑up
• Process and maintain correspondence received from patients and insurance companies as it pertains to correct and timely billing of claims, and receipt of payment
• Handle submission of issues to coding for review to ensure organizational and revenue cycle processes are followed
• Communicate appropriately with insurance companies, patients, co‑workers and supervisors
• Ensure compliance with Tribal, federal, state, and local employment laws and regulations, Tribal policies and TERO ordinance

It is the intent of this job description to highlight the essential functions of the position; however, it is not an all‑inclusive list. The incumbent may be called upon and required to follow or perform other duties and tasks requested by his/her supervisor, consistent with the purpose of the position, department and/or the Kenaitze Indian Tribe's objectives.

• Sedentary work – Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met

• Stand or Sit (Stationary position)
• Use hands/fingers to handle or feel (Operate, Activate, Use, Prepare, Inspect, Place, Detect, Position)
• Talk/hear (Communicate, Detect, Converse with, Discern, Convey, Express oneself, Exchange information)
• See (Detect, Determine, Perceive, Identify, Recognize, Judge, Observe, Inspect, Estimate, Assess)
• Repetitive Motion

• Exposure to Fumes
• Exposure to Dust
• Noise

• Category III – Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid

List Equipment used for job:
Computer, Telephone, Copier, Printer, Calculator

• Local
• Out of State

• Associate degree preferred or a combination of education and experience in a related field may be substituted for a degree.

• One year (1) of experience in Tribal Medical Billing, Federally Qualified Health Center (FQHC) Billing, or related work

• AAPC, Certified Professional Coder & Biller (CPC, CPB, COC), Certified Revenue Cycle Specialist (CRCS, CRCP), Certified Revenue Integrity Professional (CRIP)
• Knowledge and experience working with cultural diversities

• Must have a valid Alaska State driver's license and must remain…