Revenue Cycle Management Specialist - Ryan Health | Women & Children's

Position Overview

Under the direction of the Director of Application Support, the Revenue Cycle Management (RCM) Specialist will be responsible for evaluating and improving billing and revenue cycle management processes. The RCM Specialist will evaluate billing and RCM needs under the guidance of Director of Billing and ensure proper system build and billing setup to improve back-office operations. The RCM Specialist will discover and deliver new capabilities of Electronic Medical Record/Practice Management system. The RCM Specialist will serve as a liaison between billing and technology teams. This work shall be conducted in support of the mission and goals of Ryan Health.

Essential Functions

• Coordinate with Billing and Finance leaders on identifying billing, AR and revenue cycle gaps.
• Develop and implement optimized workflows to address identified gaps.
• Evaluating Billing and Finance needs. Ensure proper system build and billing setup. Creating and educating users on workflows. Maintaining documentation for future user training.
• Making workflow recommendations for front-end and clinical staff to improve back-office operations.
• Improvements for RCM workflows through claim edits, rule engine and other available resources within billing software
• Evaluate and learn new capabilities of the EMR/PM system and implement new capabilities.
• Serve as the Liaison between billing and Information Technology Team.
• Identify or develop standardized reports or dashboards to monitor billing and Revenue cycle activities.
• Analyze financial health of the practice and provide periodic reports to CFO on billing matrix including reimbursement, denials, Account receivable, trends, and patterns.
• Maintain EMR/PM billing system setups including but not limited to provider, insurance, sites, fee schedule and billing codes.
• Assist in report production, maintenance, and support of the IT Systems.
• Attend all meeting and/or training sessions as required.
• Other special projects/assignments, as needed.
  
  

Minimum Experience And Skills Required

• Minimum four years of experience with Medical billing and Revenue Cycle processing
• Minimum two years’ experience with eClinicalworks practice Management and Billing systems.
• Experience in Electronic Health Record (EHR) applications; eClinicalWorks (eCW)
• Understanding of systems analysis, workflow design, and data integrity technique
• Experience in IBM Cognos report writing software.
• Experience with database development and management.
• Experience in Project Management Methodology
• Excellent communication and interpersonal skills
  
  

Education, Licenses And/or Certifications Required

B.A. or B.S., preferably in Information Technology, Management, or Health Care, or High School Diploma and five (5) years of equivalent work experience.

Preferred Qualifications

• Certificate in medical billing
• Certification in eClinicalWorks
• Experience with Cognos, Power BI and BridgeIT
  
  

Competencies Required

Customer Service:

• Professional, courteous and respectful conduct when dealing with fellow employees: IT staff, management and clinicians
• Commitment to work towards the goals, strategy and mission of the organization as set forth by management
  
  

Cooperation/Teamwork

• Works well with others
• Contributes input to improve outcomes
• Asks others for opinions and feedback; provides feedback in a tactful and respectful way
  
  

Minimal Training Time

90-day introductory period.

Working Conditions

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is frequently required to sit, talk and hear.

The employee is occasionally required to move about the office; use hands and fingers to feel, handle, or operate office equipment.

Specific vision abilities required by this job include close vision and the ability to adjust focus.

Work Environment

The work is primarily in a mental health clinic and/or general primary care setting which includes the unpredictability in behaviors of individuals and acute and chronic infectious diseases which may be contagious. Adequate preparation and precaution is necessary.

Disclaimer

The duties listed above are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position. This position may be required to perform other duties. If such work becomes a permanent and regular part of the job, a new description will be prepared.

Equal Opportunity Employer

Ryan Health is an Equal Opportunity / Affirmative Action Employer and does not discriminate because of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, gender identity, military veteran status, or any other characteristic protected by law. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce.