Revenue Specialist
Revenue Specialist
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Salary Not Disclosed
1 Vacancy
Job Description
Overview
Presbyterian is seeking a Revenue Specialistto join our team.
Revenue specialists are primarily responsible for posting corrections and unit revenue reconciliation. Provide knowledgeable responsive and timely resolution to departmental billing charge posting discrepancies. Responsible for entering patient charges reviewing and reconciling daily transaction reports to ensure completeness and accuracy of all charge entries for patients. Responsible for monitoring changes to the individual charge masters within his/her respective business unit. Communicates with revenue finance and compliance to ensure that billing coding and documentation practices are current and compliant. Ensure that all charges are entered accurately and conform to compliance issues set by finance regulatory agencies. Responsible for coding modifiers related to charges. Stays current with regulatory requirement and provide education to clinicians and leaders. Responsible for quality management of documentation and billing for adherence to regulatory requirements.
Type of Opportunity: .5/20hr days
Work Schedule: 8 Hour Days
Were all about well-being starting with yours.
Presbyterian employees have access to a fun engaging and unique wellness program including free on-site and community-based gyms nutrition coaching and classes mindfulness and meditation resources wellness challenges and more.
How you grow learn and thrive matters here.
- Educational and career development options including tuition and certification reimbursement scholarship opportunities
This position is eligible for the Northern New Mexico differential of $4.00 per hour. (This differential may be adjusted or discontinued based on business requirements.)
Qualifications
- High School diploma/GED required.
- One to three years experience in a healthcare reimbursement/business office environment to include data entry clerical and financial functions and billing and account reconciliation.
- Systems operations knowledge of at least one patient accounting system EPIC and other revenue cycle systems. PC experience with Microsoft Office Word and Excel.
- Knowledge of CPT ICD-10 and HCPCS coding.
Responsibilities
Responsible for reviewing updating and posting charges
Communicate with revenue and finance to ensure charge entry and posting comply with CMS DOH TJC and other regulatory agencies
Listen analyze answer resolve and coordinate charge master and billing inquiries across network service areas
Document responses and resolutions to charge master inquiries in information systems for tracking and reporting
Access online systems and hard copy documentation to resolve charge master issues
Maintain effective communication with clinical staff managers supervisors administrative assistants and finance
Review billing and charge master transaction summaries daily for accuracy and completeness
Reconcile daily billing activity to ensure correct charge entry
Maintain confidentiality of all patient information
Establish and maintain relationships with revenue compliance and finance teams
Assist PHS system personnel in researching questions inquiries and statistical checks
Maintain department statistics and compile data for clinician and department scorecards
Respond to daily inquiries regarding financial statistics billing auditing and charging
Act as liaison to Manager Finance/Revenue and Compliance for auditing coding compliance and training issues
Perform quality assurance audits of patient accounts for regulatory compliance accurate coding and proper documentation
Identify and resolve compliance and reimbursement issues to ensure accurate claims submission
Develop and deliver training and technical knowledge to Presbyterian employees
Assess learning and performance needs of staff and target audiences
Create training materials and provide initial and ongoing staff training
Identify billing and collection practices inconsistent with contracts and regulations
Summarize audit findings and provide recommendations to management
Benefits
Were all about well-being starting with yours.
Presbyterian employees have access to a fun engaging and unique wellness program including free on-site and community-based gyms nutrition coaching and classes mindfulness and meditation resources wellness challenges and more.
Learn more about our employee benefits.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients members and the communities we serve. We are a locally owned not-for-profit healthcare system comprised of nine hospitals a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908 we are the states largest private employer with nearly 13000 employees - including more than 1200 providers and nearly 3500 nurses.
Our health plan serves more than 640000 members statewide and offers Medicare Advantage Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
Maximum Offer for this position is up to
Compensation Disclaimer
Required Experience:
Unclear Seniority
Employment Type
Part-Time
