Revenue Specialist - Lansing, United States - Mid Michigan Recovery Services Inc

Description

Job Description

Mission Responsibility

The Revenue Specialist is responsible for billing and invoicing accounts receivable for the agency. The Revenue Specialist collects and analyzes encounter data; corrects errors and omissions; submits by payor deadlines; reconciles the electronic data interchange 837 from payors; and repeats the cycle to an agreed level of efficiency.

Duties and Responsibilities

Fee for Service Billing

1. Analyzes encounter bed nights; makes report of errors and omissions; organizes billing batches, exceptions; corrects or reports errors and omissions and submits billing to payor deadlines
2. Submits and reconciles electronic data interchange format 837 and 835 files monthly (Biweekly desired)
3. Reviews Current Procedural Terminology (CPT) codes, corrects errors and rebills to claim-value priority: the revenue cycle
4. Tracks and groups claims by their status and age; paid, curable, uncurable and invalid; 30, 60 90 and 90 days and above. Keeps these categories in spreadsheets updated by month.
5. Assists chief financial officer and executive director for preparation of month end Outstanding Claims Report for agency financials

Grant and Self Pay Revenue

1. Works with accountant
   1. To submit monthly financial status reports for Medicaid contracts
   2. Track self-pay accounts maintains account aging

Accounting and Continuous Improvement

1. Makes lists of problems, solutions, ideas and reports to executive director and leadership team
2. Serves on Technology Action Committee and leads/serves on project teams
3. Maintains user access to payor-hosted and required data systems
4. Works with the office manager to meet and maintain provider credentials
5. Maintains the report list and shares with leadership team
6. Works with the systems administrator on audit tasks as assigned
7. Assists executive team with payor and Council on Accreditation of Rehabilitation Facilities (CARF) audits
8. Performs duties as assigned to comply with agency Finance and Accounting Policies and Procedures

Additional Responsibilities:

1. Strictly adheres to all federal and state laws, rules and regulations, HIPAA, 42 CFR Substance Abuse Treatment and organizational policies and procedures
2. Promotes MMRS philosophy and mission through personal attitudes, actions and behaviors
3. Complies with agencies conflict resolution protocols
4. Other duties as assigned

Supervisory Relationships

Serves in the executive office of the agency. Reports to the executive director, works collaboratively with the systems administrator, chief financial officer, accountant, assistant directors, clinical director, and leadership team as assigned.

Qualifications

Associate's degree in a related field with 2-3 years' experience in medical billing or an equivalent combination of education and experience. Proficient with electronic medical records, Microsoft Excel, familiarity with Word. Demonstrated understanding of basic billing concepts and strong mathematical acuity required. Ability to analyze, parse, sort and order work sheets and maintain them.

If recovering from a substance use disorder, must be able to demonstrate a period of continuous sobriety sufficient to carry out job responsibilities.

Work Conditions

MMRS is a healthcare provider. Additional stress and risk may be encountered during critical situations commensurate with our license and scope of practice to ensure the health and safety of our clients. Position is deadline driven by payor due dates, monthly and annual reconciliation. Limited, off-site time available to meet deadlines and assigned deliverables coordinated with executive office schedules.

Compensation/Benefits

competitive pay based on experience and education.

• 401(k) Matching
• Dental Insurance
• Vision Insurance
• Life Insurance
• Health Insurance
• Paid time off
• Paid Holidays