Revenue Cycle Specialist (FT)

• EDUCATION (must be required for position), LICENSE, CERTIFICATION and EXPERIENCE:

Education: High School Diploma, or GED preferred.

Licenses: No professional license required.

Certifications: No certifications required

Experience: Minimum of 2-3 years of experience in medical billing, coding, or revenue cycle management. Experience in a healthcare setting is preferred.

REQUIRED SCREENINGS:

Drug Screen

Physical Assessment

Tuberculosis screen

Background check (Criminal, Civil, Educational, Previous Employment, etc.)

Driver Record screen (positions requiring on-the-job driving)

ESSENTIAL FUNCTIONS:

GENERAL DUTIES:

• Reliable and punctual attendance is essential; expected to be at job as scheduled each scheduled day.
• Billing: Process patient accounts, ensuring that all charges for medical services are billed accurately and in accordance with healthcare regulations. Working with coding for accuracy and completeness.
• Insurance Verification & Authorization: Verify insurance coverage for patients, ensuring that required authorizations and referrals are obtained for services.
• Claims Management: Submit insurance claims in a timely manner, following proper coding and billing protocols. Ensure compliance with insurance guidelines and address

any rejections/denials promptly.

• Payment Reconciliation: Reconcile payments and resolve discrepancies between payments and charges.
• Denial Management: Investigate denied claims, working with insurance carriers and patients to resolve issues. Follow up on unpaid or underpaid claims to ensure timely

reimbursement. Document all actions taken for future reference.

• Patient Billing &Customer Service: Assist patients with billing inquiries, ensuring that they understand charges, insurance payments, and balances. Provide support for payment plans or financial assistance programs if necessary.
• Compliance & Documentation: Maintain up-to-date knowledge of insurance policies, billing codes, healthcare regulations, and compliance requirements to ensure accurate and legal billing practices.
• Collaboration: Work closely with other departments such as clinical staff, coding, and finance teams to ensure proper documentation and smooth workflow throughout the revenue cycle.

GENERAL SKILLS:

• Strong attention to detail with a high level of accuracy.
• Knowledge of healthcare billing standards using (ICD-10, CPT, HCPCS).
• Familiarity with insurance verification, claims submission, and denial

management..

• Proficiency in using healthcare management software (e.g., Epic, Cerner,

PCIS,ECW). (Preferred, but not required)

• Strong communication skills, both verbal and written, for patient interactions and

collaboration with internal teams.

• Attention to detail and accuracy in processing billing and claims.
• Ability to communicate effectively with insurance companies, patients, and

internal teams.

• Knowledge of HIPAA regulations and healthcare compliance

ORGANIZATIONAL EXPECTATIONS:

• Be responsible for my own attitude.
• Be open to constructive feedback and suggestions for improvement; accept constructive feedback in a positive manner.
• Be generous with my skills and abilities by educating others on new ideas and/or techniques; offer constructive input to support the work area appropriately and respectfully.
• Take responsibility to attend or obtain information provided at in-services, seminars and staff meetings.
• Demonstrate, through my actions and speech, that I represent the entire organization. I will take action to ensure that a need is met; emulate the mission and vision statements.
• Acknowledge and greet everyone; look approachable, with open body posture, eye contact and a smile; communicate appropriately using good interpersonal skills.
• Dress professionally and appropriately for my work environment.
• Know and follow policies and procedures for both organization and department safety issues.
• Communicate delays in services and take service recovery steps as needed.

WAGE starts at $18.37 per hour and goes up based on experience

Immunizations required for employment

FHW offers a full benefits package including:

FOR ALL EMPLOYEES:

Employee Assistance Program

403 (B) with 4% match from FHW and zero day vesting schedule

FOR FULL TIME EMPLOYEES WORKING AT LEAST 30 HOURS A WEEK

Medical Plan Options:

• PPO plan with copay/coinsurance and lower deductible
• High Deductible Health Plan with the option for a Health Savings Account.
• Telemedicine includes in both plan options.

Dental

Vision

Life Insurance/ Accidental Death and Dismemberment Insurance

Disability Insurance with a Short and Long Term Option.

Critical Illness and Accident Plans

Cafeteria Options: Health Reimbursement/ Flex Savings

A host of other options to include: Pet Insurance, Identity Protection, Travel protection, etc.