Revenue Operations Specialist - Non-Profit

About the role

Ahrc

New York City is seeking a Revenue Operations Specialist. The Revenue Operations Specialist is expected to mentor, aide and assist Revenue Operations Coordinators as needed. In addition, the Revenue Operations Specialist will provide back-up to the Revenue Operations Manager or Clinical Billing Manager as necessary to ensure all billing/posting deadlines are obtained.

COMPENSATION: $55,000-$60,000 per year plus a very generous and comprehensive Benefit package. See additional Benefit information below. ESSENTIAL RESPONSIBILITIES The Revenue Operations Department has multiple billing systems utilized to successfully bill many of the services provided to clients at AHRC NYC.

The Revenue Operations Specialist will work on multiple billing system environments, external payer portals or government sites to complete the necessary activities for eligibility determination/evaluation, billing, payment posting or filing necessary appeals. Below are examples of the key functions performed by the Revenue Operations Specialist, this is NOT an all-inclusive list of duties.

Serves as super user of the billing software systems and acts as a mentor and resource to other team members and department-based users in development of skill sets and application knowledge.

Analytical investigation and necessary action for rejected or denied claims including but not limited to: Submission of an appeal to the original decision, Correction of the original submitted claim for resubmission to the payer, Secondary billing post response received from the Primary payer, or Completion of self-pay billing or write-off action to resolve the claim.

Review of system aging accounts on a weekly basis to conduct appropriate follow up activities. Apply analytical strategies for the identification of inconsistencies or trends in weekly billing and posting activities that may present system functionality issues or identifies a breakdown in program/clinic practices that may be negatively impacting billing or collection.

Collaboration with inter-agency departments regarding billing, collections, and compliance matters. Prepares self-pay, liability billing or other forms of vouchers and billing as needed. Medicaid, Medicare and / or Managed Care billing, posting and reconciliation across multiple billing systems, clearinghouses and/or billing portals.

Works with the compliance department on billing changes, voids or write-offs that may be necessary to complete and perform the applicable action. Works with management to improve billing practices, guidelines, and department procedures to ensure efficiency, reduce denials, maximize reimbursements and promote faster payments.

Assist in the training or retraining to current and new employees on use of systems and departmental policies and procedures. Independently lead initiatives assigned by management, coordinate tasks as necessary to deliver results. All team members are responsible to perform back-up duties as defined to cover for vacancies, vacations, extended leave of absences or as the department requires to maintain billing deadlines.

Perform ad-hoc tasks as assigned.

Required Qualifications

Analytical problem solving to diagnose and troubleshoot root problems with process, payer and system functionality that impacts revenue cycle objectives. Associate Degree in Healthcare Administration, Business Administration or equivalent job-related experience.

(Bachelor's Degree desired) Minimum of three years' experience in a physician's office, clinic, hospital business office or related area dealing with insurance follow up and denial management or two years' experience in Atypical billing, OPWDD, Medicaid Waiver, Article 16, and/or Article 31 billing and denial management. Applied intermediary to expert level experience Microsoft Word and Excel.

• Strong adaptability to old and new billing software products, government and payer portals.
• Strong interpersonal skills, verbal and written communication, for collaboration with key stakeholders.
• Ability to prioritize and handle multiple tasks in a dynamic work environment and make independent decisions.