Revenue Cycle Specialist

OakLeaf Clinics - Business Office

OakLeaf Clinics - Business Office has an exciting opportunity to join our team as a full-time revenue cycle specialist, primarily focused on services, invoices, reports, and more for the direct primary care program, OakLeaf Direct.

OakLeaf Clinics is dedicated to providing our patients with compassion, trust, and a lifetime of individualized care. Our healthcare team consists of physicians, nurse practitioners, certified nurse midwives, nurses, and medical assistants working in concert with laboratory/imaging services to offer individualized care to the Chippewa Valley.

Position description

The revenue cycle specialist serves as a strategic partner to the revenue cycle team. Working collaboratively with leadership, you will identify, analyze, and improve upon existing processes to drive efficiency. You will be a partner in identifying and communicating trends within billing, payment posting, prior authorization, and customer service. Understanding, interpreting, and communicating key revenue cycle and productivity data will be crucial in developing innovative solutions. You will also play a critical role in supporting the leadership team by providing education and training to team members.

As a revenue cycle specialist, you will ensure the highest level of compassionate, patient-centered care is provided to our patients through analyzing data and trends, driving quality improvements, and educating team members.

Responsibilities

• Reinforce and abide by our values of patient first, respect, teamwork, joy, innovation, and continuity of care
• Maintain a positive work environment by ensuring employees are held accountable for daily activities, performance, and behavior
• Produce, analyze, and distribute standard periodic reports such as AR aging, denials, collections, revenues by provider/location/payer, and revenue forecasts based on payer mixes and rates
• Complete data extraction from the Electronic Medical Record (EMR) system
• Monitor cash flow applied to AR to analyze deficiencies and apply corrective action to assure accurate and timely receipt of payment from patients, government agencies, and commercial insurers
• Analyze, understand, interpret, and communicate key revenue cycle and productivity data to determine current performance and identify areas needing improvement
• Analyze practice fees on an annual basis and make rate recommendations to the director to ensure appropriate income/cash flow
• Participate in various committees to provide input from a business office perspective
• Analyze revenue cycle data, prepare revenue forecasts, and perform trend analysis
• Prevent payment delays by handling account queries and entering various types of billings in multiple states by designated deadlines
• Present revenue cycle reports and forecasts, as well as identify opportunities to increase revenue
• Ensure the collection of current and aged accounts, and provide follow-up as needed
• Investigate complaints from internal and external customers to verify the accuracy of charges and to correct errors in accounts
• Collaborate with leadership in the development of action plans to address deficiencies and monitor performance improvement
• Adhere to all federal, state, and company regulations, policies, and procedures
• Review and implement processes surrounding admissions, billing, compliance, collections, and other financial analyses to ensure that the clinical revenue cycle is effective and properly utilized
• Manage relations with payers and providers to generate high reimbursement rates and a low level of denials
• Retrieve and compile data from multiple billing systems to produce trending analysis, outcome measures, and key performance indicators tracked on the RCM dashboard
• Stay abreast of state and federal regulations and governing policies for behavioral health services, specifically in foster care agencies and community outpatient services
• Collaborate with leadership to establish, modify, and recommend efficient practices to maintain compliance with insurance requirements
• Conduct quality assurance reviews and relays potential high-risk or non-compliant information found during the review and/or audit of the client's billing records
• Carry out other duties as assigned

Qualifications

• Associate degree (preferably in health information technology or medical office specialist), two years related experience (in EMR/EHR systems, accounts receivables, health information management, utilization review, quality assurance, or training), or equivalent combination of education and experience
• Minimum of three years of experience in accounts receivables, healthcare billing, performance improvement, and payer contracts
• Minimum of three years of experience in a physician practice revenue cycle
• Previous experience as a biller/analyst
• Knowledge of business systems and design
• Knowledge of ICD-10 and CPT coding is preferred
• Working knowledge of the Microsoft Office Suite
• Epic Super User with extensive experience in Epic and other informational systems used within the clinics related to coding and billing, including the ability to assist with interfaces, setup, and maintenance of such systems
• Ability to effectively communicate and work efficiently with administration, physicians, patients, and staff
• Ability to demonstrate independent judgment and initiative

Work environment

While performing the duties of this job, the employee regularly works in an office setting.

Physical demands

The physical demands described here are representative of those that an employee must meet to perform the essential functions of this job successfully. Major activities of this job include sitting or standing for long periods and performing light physical effort on a level surface. Some activities, such as carrying, lifting, kneeling, bending, reaching, and squatting, are involved in the office. Use a computer and telephone, and employ writing and organizational skills. Manual dexterity, mobility, and good vision, including near acuity, depth perception, and accommodation, are physical requirements necessary for technical work.

Salary: $25 per hour, commensurate with experience
Education: Associates
Job Type: Full Time
Experience: 2+ years
Location: 719 W Hamilton Ave, Suite B • Eau Claire, WI 54701

To apply, please send cover letter and resume to:

Carissa Eppens, Human Resources Administrative Assistant

OakLeaf Clinics
719 W Hamilton Ave, Suite B, Eau Claire, WI 54701

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