Sr Revenue Cycle Specialist

Summary:

Reports to the Clinical Manager of Radiation Oncology. Collaborates with radiation oncology staff and patient financial services.

Responsibilities:

Versatile in all aspects of the Revenue Cycle through Resolution of all patient claims.

This position updates demographic and insurance information for accuracy on all patients.

Collects and follows up on all accounts assigned prior to during or after admission and discharge. Communicates Lifespan Cancer Institute�s financial policies to all patients. Identifies patients who require financial counseling intervention; provides information regarding resources for patients who need financial help after discharge and/or during collections and follow up activities.

Partners with patient financial services to verify research and completes all paperwork and forms to bill all types of claims for reimbursement. Serves as a patient advocate during the cycle of the account. Assist with departmental workflow as needed.

Identifies and notifies leadership of issues and initiates appropriate action for resolution. Serves as point person for employee questions. Maintains thorough understanding of insurance payment reimbursement account reconciliation referrals authorizations and account follow-up to secure reimbursement of claims. Provides support to leadership facilitating quality improvement by reporting problems concerns and opportunities for increased revenue and decreased denials through the quality assurance process.

Assists in training and development of new staff members. Must be able to review and operationalize contracts as it relates to billing and reimbursement of complex claims.

The position may be responsible for understanding and maintaining knowledge of standard for care of specific radiation oncology population. Provides liaison and educational services in support of standards. Identifies and resolves financial issues relating to all patients.

Manages coordinates and champions multiple revenue cycle initiatives across the department to improve processes and support the revenue cycle mission.

Demonstrate understanding of key revenue cycle areas that impact the patient experience - including but not limited to: insurance verification pre-registration financial counseling billing collections and customer service.

Collaborates with revenue cycle associates and vendors to prepare performance metrics and analysis.

Manages coordinates and champions multiple revenue cycle initiatives across the organization to improve processes and support the revenue cycle mission.

Other information:

EDUCATION and EXPERIENCE:

Bachelors Degree with a minimum of five years of relevant experience; OR any combination of equivalent education and experience.

• Certified Patient Accounts Representative (CPAR) and/or

• Certified Patient Financial Counselor (CFC).

• ROCC (Radiation Oncology Certified Coder) AMAC

If not certified must be obtained within eighteen months of employment

Problem solving skills are required as the applicant must be able to use various tools analyze the situation research data and resolve and/or formulate a decision. Works closely with Management in formulating and implementing departmental objectives toward enhancing the work flow of the department.

This position requires heavy phone and computer usage and a detailed knowledge of applicable EMRs patient accounts payer and financial tools. Additionally education sessions and insurance payor forums should be attended as appropriate.

Specialist is required to review analyze and understand the Managed Care Contracts and various aspects of patient care to maximize reimbursement. This includes but is not limited to radiation oncology patients. Knowledge of payer requirements including pre-cert requirements splitting of claims analyzing payments researching complex payment variances are critical for patient and/or account resolutions.

The Revenue Cycle Specialist must be able to work independently. They must have excellent verbal written analytical and interpersonal communication skills.

Professionalism must be maintained at all times regardless of circumstances. Organization skills are also very important. Other job duties as assigned pertinent to the Revenue Cycle. Performs other duties as required

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs 0-33% of the work day (occasionally); 11-25 lbs 34-66% of the workday (frequently); 01-10 lbs 67- 100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking Occasional sitting Close eye work (computers typing reading writing) Physical demands may vary depending on assigned work area and work tasks. ENVIRONMENTAL FACTORS:

Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock Floor Surfaces Hot/Cold Temperatures Indoor/Outdoor conditions Latex Lighting Patient care/handling injuries Radiation Shift work Travel may be required. Use of personal protective equipment including respirators environmental conditions may vary depending on assigned work area and work tasks

SUPERVISION:

None

Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Lifespan is a VEVRAA Federal Contractor.

Location: Rhode Island Hospital USA:RI:Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union