Spec Revenue Cycle Sr

We are recruiting for a motivated Spec Revenue Cycle Sr to join our team!

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Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all :

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Department

Billing and Collections

Job Summary

The Revenue Cycle Specialist Senior works under general supervision. This incumbent provides financial, clerical, and administrative services to ensure efficient, timely and accurate reimbursement of all inpatient / outpatient hospital and physician claims submitted by Hospital and Physician Services. The incumbent corresponds with insurance companies, patients, guarantors, providers, attorneys, and other partners to resolve unpaid balances in a timely manner. Delivers customer service, billing, follow-up, cash application processes, reconciliation of payer remittances, denial management and appeal functions. Provides financial guidance on self-pay accounts. Investigates delinquent accounts for legal liability. This role requires exceptional knowledge of insurance rules, payor specific guidelines, regulatory requirements, claim submission, processing, and collections. Individuals in this role must possess strong attention to detail and excellent communication skills, both verbally and in writing. This position requires an individual that can correspond professionally and competently on escalated issues / concerns, as well as higher level detailed situations. This role serves as a resource and mentor for junior members. Assists in leading and openly supporting management in projects, training, and organizational initiatives to achieve departmental and cash goals.

Essential Functions :

Maintain detailed knowledge of revenue cycle functions and metrics. Work accounts receivables to ensure timely payments from insurance and / or patients. Initiates claims submissions, performs review of accounts, ensures work performed is accurate and complete. Documents contact with patients, guarantors, insurance companies and others using the appropriate methods. Identify trends, conduct follow-up, and perform root cause analysis on unpaid and underpaid accounts.

(50%)

Trains staff, responds to inquiries and complex questions and collaborates with Supervisor to develop training material and standard of work for the department. Builds trusting relationships with internal and external departments / business partners by providing confident leadership and timely communication.

(20%)

Completes worklists and / or reports as assigned. Performs deep-dive analysis of KPI's, identify underlying drivers, uncovers new insights, and makes data-driven recommendations to stakeholders which results in improved business and performance.

(15%)

Utilizes various payer systems, provider portals, and internal applications.

(10%)

• Reviews websites, bulletins, etc., to keep current knowledge of regulatory requirements. Relays updated information to key stakeholders regarding policy changes. (5%)

Education :

Work Experience :

Licenses :

Knowledge, Skills and Abilities :

Shift

Work Type

Regular

Salary

$23.97 - $35.96 / hr

Benefits

Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans

Free RTD EcoPass (public transportation)

On-site employee fitness center and wellness classes

Childcare discount programs & exclusive perks on large brands, travel, and more

Tuition reimbursement & assistance

Education & development opportunities including career pathways and coaching

Professional clinical advancement program & shared governance

Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program

National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

Our Values

Respect

Belonging

Accountability

Transparency

All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.

Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver's 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation.

As Colorado's primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.

Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community.

Applicants will be considered until the position is filled.