Job description

HUMAN RESOURCES

VACANCY ANNOUNCEMENT KCHC37-2022

Position: Revenue Cycle Specialist

Opening Date: December 02, 2022

Closing Date: Continuous

No. of Vacancies: 1

Salary: $12.54/hr - $21.00/hr

The salary given will be determined by the qualification of the appointee.

Location: Kagman Community Health Center, Inc.

Kagman Commercial Bldg., Kagman Rd., Kagman III

Duties:

Under the direction of the Chief Financial Officer, the employee in this position is responsible for managing the flow of money into and out of the organization and all transactions are handled properly, this includes everything from collecting payments to handling customer inquiries about billing issues. He/she will be responsible for ensuring that all claims are submitted correctly and in a timely manner, as well as working with insurance companies to resolve any issues that may arise. Sorts and files paperwork and handles insurance claims. Manages open invoices. Prepares monthly A/R reports, reviews open invoices for resolution, meets with providers to show account status. Manages patients with past due balances. Ensures that billing is done correctly. Assists with strategic planning to decrease denials and increase collections. Produces and manages billing reports related to charges, payments, denials, interprets data, and develops improvements. Audits post-op visits routinely to ensure that visits are billed within the global period and vice versa. Assists in educating staff as required on billing issues and changes. Routinely reviews regulatory and third party payer changes impacting revenue cycle operations. Coordinates the revenue cycle operational needs for new programs and sites to ensure effective capture of patient registration information and billing requirements. Payment postings and reconciliations - back-up to Accounts Receivable Clerk. Maintains records and files as appropriate. Interacts with employees, medical center administrative staff, physicians and office staff. Perform quality assurance checks to ensure procedures are adhered to. Maintains training strategy and plan. Assists in managing the flow of information between the various teams and departments needed to ensure accuracy. Closed visits are reviewed for possible billable services, if found then charge is manually entered through AdvancedMD, if no code found, then review of scheduled appointment for validation and/or cancellation. Supports manager/supervisor in identification of potential lost revenue related to trends in charge entry, billing, coding or contracting practices that are related to charge capture. Verifies all of the information for claims billing is correct in AdvancedMD. Contacts the appropriate person to obtain missing or unclear billing information. Documents all tasks in AdvancedMD notes/history. Reviews all invoices to determine the correct billing method. Completes claim form through AdvancedMD ensuring that all fields required by the third party in question are complete and accurate. Attaches required documentation for payment. Follow up by phone on all unpaid and denied claims through activities in AdvancedMD. Determines next course of action, which may require rebilling missing claims, denied claims or sending additional information on pending claims. Handles third party customer questions, complaints, and problems once invoiced. Completes all necessary follow-up in a timely manner so the payment process will not be delayed. Must stay current on follow ups, so billing deadlines are not missed. Respond to and interact with customers concerning all aspects of billing through phone, e-mail or regular mail in a prompt and courteous manner. Relays changes in Medicaid, Medicare, private insurance regulations discovered by claim denials to all pertinent personnel. Performs other duties as required and assigned by the CFO.

Qualification Requirements:

Bachelor’s Degree in business, accounting, finance, or related fields. Minimum of four (4) years experience working in revenue cycle management, billing, or collections. Must have excellent knowledge of medical and billing coding. Expertise in Medicare, Medicaid, and insurance billing and reimbursement. Ability to work effectively with coworkers and clients. Must have good oral and written communication skills. Comprehensive of basic medical information. Computer literacy necessary.

Conditional Requirements:

This position is a full-time employment status. The regular work schedule will be Monday to Friday from 7:30am to 4:30pm for a total of 40 hours per week. This work schedule however is subject to change with or without notice based on the Employer’s business requirement and/or by the demands of the employee’s job; Every effort will be made to adhere to the employee’s regular work schedule. This position is “COVERED” and is eligible to receive overtime compensation pursuant to the Fair Labor Standards Act (FLSA).

Other:

This position is paid on bi-weekly basis (two [2] week period). KCHC adheres to all applicable deductions such as CNMI tax, Federal Tax, Medicare and Social Security.

Note: Education and training claimed in Employment Application must be substantiated by diploma, certificate or license. Failure to provide complete application form or the required documents will result in automatic disqualification.

(“This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number 22H80CS31624 for Health Center Program. This information, or content and conclusions, are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.”)

INTERESTED PERSONS SHOULD SEND THEIR APPLICATION FORMS TO:

Kagman Community Health Center, Inc.

Kagman Commercial Bdlg., Kagman Rd., Kagman III

Operations Officer

Norma DLG Borja

Phone: (670) 256-5242/3/7 ext. 1023

Fax: (670) 256-5244

Job Type: Full-time

Pay: $12.54 - $21.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Paid time off

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

COVID-19 considerations:
All Staff and patients are required to wear a mask, check their temperature, and log in to COVID questionnaires. The clinic is sanitized hourly and after every patient.

Application Question(s):

• Are you residing in Saipan, CNMI?
• Are you fully vaccinated against COVID-19?

Education:

• Bachelor's (Preferred)

Experience:

• Revenue Cycle: 4 years (Preferred)

Work Location: One location

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