Kadlec Revenue Cycle Business Specialist in Richland, Washington
Providence is calling a Revenue Cycle Business Specialist to Providence Health & Services in Richland, WA.
We are seeking a Revenue Cycle Business Specialist to assist department management in identifying, establishing, implementing, and monitoring business and financial related processes that contribute to the successful operations of the Revenue Cycle. Coordinates the facilities denials management process to ensure the hospital receives appropriate reimbursement for services provided. Works cooperatively with Revenue Cycle department employees and managers for the purpose of achieving departmental goals and ensuring maximum revenue and a cash flow benefit to the Hospital. This position will be involved in the process of developing and implementing reporting of denials, recommending process workflow improvements and reporting of compliance concerns.
In this position you will have the following responsibilities:
Embraces Planetree philosophy to provide a safe, comfortable, therapeutic, patient-centered environment.
Maintains a collaborative working relationship with external health care professionals, Information Technology personnel, hospital managers and other hospital staff to optimize reimbursement and compliance with applicable laws, regulations and in agreement with third party payers.
Assists with writing policies and procedures for the development, implementation and maintenance of processes associated with the hospital’s denials functions.
Works with Epic and the Instructional Designer to develop and implement a denials reporting process.
Organizes and monitors workflow to ensure denials are worked according to Patient Financial Services standards and policies.
Serves as a primary point of reference for all denials worked and as the main point of contact for any outsourcing of denials.
Communicates denial information to clinical department’ by preparing and facilitating educational sessions based on needs identified from denial data.
Provides assistance with compliance training and educational programs to ensure employees are knowledgeable with the denials and billing compliance programs; provides reference materials to promote continued education on patient accounting practices and compliance in an effort to minimized denials.
Required qualifications for this position include:
Associate’s Degree from an accredited educational institution. 3 years of job description specific experience may be considered in lieu of Associate’s Degree.
2 years healthcare or business related data analysis experience.
Information Technology/Systems experience.
Personal computers, 10-key calculator, scanner, fax, telephone and copy machine.
Requires normal/corrected vision and hearing to normal range. Typically sitting at a desk using personal computer but includes intermittent standing, walking, stooping, and requires a full range of body motion including lifting boxes of paper weighing 30 lbs. Requires good manual and finger dexterity to handle paper and operate equipment.
Knowledge of office practices, procedures and equipment including computers, typewriter, calculator, scanner and HPF (Horizon Patient folder).
Knowledge of Kadlec Regional Medical Center’s billing and payment system.
Knowledge of mathematics, accounting, clerical skills and record-keeping techniques.
Knowledge of interpersonal skills using tact, patience and courtesy when contacting public.
Knowledge of medical insurance including third-party payers, Medicare, Medicaid, and Labor and Industries
Knowledge of telephone techniques and etiquette.
Knowledge of third-party contractual agreements with focus on contractual percentage variations.
Knowledge of data collection, spreadsheets and statistical data analysis.
Knowledge of Federal and State laws and regulations, JCAHO and other regulatory agencies
Knowledge of current third party payer related compliance issues, such as Medicare Fraud and Abuse, educational programs and immediately reports any suspected violations to appropriate personnel.
Knowledge of HIPAA regulations
Ability to communicate effectively and tactfully, establish and maintain effective working relationships.
Ability to research and analyze data as it relates to Revenue Cycle Operations.
Ability to maintain confidentiality in all Medical Center business.
Ability to read complex data, to interpret, apply and explain codes, rules, regulations, policies and procedures.
Ability to analyze comprehensive financial reports, to problem solve and to make sound judgments.
Ability to work confidentially with discretion.
Ability to problem solve complex issues and to focus on conducting root cause analyses, reaching out to appropriate staff as needed for resolution.
Ability to communicate effectively with patients and hospital staff.
Preferred qualifications for this position include:
Bachelor’s degree from an accredited educational institution.
Bi-lingual or multi-lingual skills.
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We offer a full comprehensive range of benefits — see our website for details —
Provide safe compassionate care. We promise to answer the call of every person we serve; to know them, care for them and ease their way. We are committed to safety, compassion, respect, integrity, stewardship, excellence and collaboration.
Located in sunny Tri-Cities, WA, Kadlec is the largest non-profit healthcare provider in the region. Kadlec is the premier choice for customer service excellence, providing compassionate healthcare to the region by combining cutting-edge technology and innovation with evidence-based, patient-focused care. Kadlec is proud to be part of Planetree (Planetree.org) and continues to be recognized nationally as a “Best in Class Employer”. Kadlec does not unlawfully discriminate on the basis of race, sex, sexual orientation, age, color, religion, national origin, genetic information, marital status, veteran status, disability status, or any other characteristic protected by Federal, State, or Local Law. EOE.To learn more, click here: http://www.kadlec.org/careers/about-kadlec
Job Category: Billing / Insurance
Req ID: 181979