Who We Are:

As the only independent and physician-led faculty practice plan of the University of Tennessee Health Science Center, University Clinical Health (UCH) offers best-in-class clinical care through a network of 175+ providers across 19 specialties to meet the healthcare needs of the Mid-South community. UCH is a not-for-profit, non-tax-supported group practice and is here to serve the community while providing medical excellence to our patients.

Position Summary:

The Revenue Operations Specialist (ROS) is responsible for updating patient demographics and verifying insurance benefits. The ROS additional responsibilities will include utilizing multiple hospitals systems and various payer websites, entering alphabetic and numeric medical data from source documents into practice billing system, checking for entry accuracy, and implementing the NextGen PM claim edit edit edit correction process. The position requires overtime, both during the week and weekends, on an as-needed basis. Limited time off is approved for the last week of the month.

Key Results Areas (KRAs):

• Responsible for Patient registration, including chart creation and demographic data input
• Navigate multiple hospital systems and collect necessary patient demographic and insurance information
• Verification of insurance eligibility through RTS, payer website, or phone calls to the payer
• Utilize a variety of charge capture methods, i.e., pMD, excel spreadsheets, paper fee tickets, email, OR schedules, rounding lists, etc. and in turn, transfer that information to NextGen PM for billing
• High-level understanding of medical coding pertaining to CPT, ICD 10, modifiers, and POS codes
• Input Charge data including CPT, ICD 10, and modifier codes quickly and accurately on each transaction level/line
• Input insurance data correctly on each billable encounter in NextGen PM
• Run and review NextGen PM claim edits and investigate and correct errors or discrepancies
• Ensure up-to-date knowledge of policies and procedures pertaining to the Revenue Services department
• Maintain a working knowledge of Regulatory Compliance, especially HIPAA and CMS billing guidelines
• Foster team effectiveness by being motivated to be an integral part of the RSCE unit within Revenue Services
• Perform any other duties as assigned

Core Competencies

• Demonstrated analytical skills
• Prompt response to email and telephone calls
• Exceptional interpersonal and communication skills
• Pays close attention to detail, accuracy, and completeness
• Excellent organizational skills
• Committed to supporting UCH’s standard to medical excellence

Education & Experience:

• High School diploma or equivalent required
• 1 to 2 years medical office or medical billing experience strongly preferred
• Computer knowledge: Word, Excel preferred, Nextgen/Epic PM a plus
• Knowledge of medical terminology and insurance claim filing preferred
• Knowledge of insurance verification systems (Passport, TNAnytime, individual carrier websites, etc.) preferred
• Knowledge and/or experience with local hospital systems (Cerner, Epic, etc.) preferred

Effective November 1, 2021, UCH requires all employees to be fully vaccinated against COVID-19 (or have an approved medical or religious exemption from UCH). Please note that a job offer is contingent on submitting proof of COVID-19 vaccination or UCH approval of a medical or religious exemption request. Employees with approved exemptions will be required to undergo weekly COVID-19 testing at an assigned UCH testing location and time.

EOE-University Clinical Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, genetic information, or any other characteristic protected by federal, state, or local laws. University Clinical Health is a VEVRAA Federal Contractor – priority referral Protected Veterans requested.