Revenue Cycle Specialist
Summary
About this role
Join a Team That Changes Lives
For more than 170 years, Elwyn has been leading the way in supporting children, teens, and adults with autism, intellectual and developmental disabilities, and behavioral health challenges. As a mission-driven nonprofit, we’re here to create real change – helping people lead meaningful, fulfilling lives.
Now, we’re looking for passionate team members to join us. Here, your work will change lives – including your own. You’ll make an impact every day, find purpose in what you do, and grow in a career that truly matters.
At Elwyn, we take care of you while you care for others. We offer:
- Generous Paid Time Off
- Comprehensive Medical/Dental/Vision Benefit Packages
- Earned Wage Access/On-Demand Pay
- Paid On-the-Job Training
- Tuition Reimbursement
- Career Advancement Opportunities and Growth
- Flexible Schedules
- Retirement Savings Plan
Join us and be a part of something bigger. Apply today.
Job Description
Elwyn seeks a Revenue Cycle Specialist who is responsible for ensuring that the billing department accurately submits claims and/or encounters for clinical services and adheres to claim submissions deadlines. Extensive knowledge of medical terminology, Current Procedural Terminology (CPT) coding, International Statistical Classification of Diseases and Related Health Problems (ICD) coding, Medicare Revenue Codes, UB-40 and Healthcare Common Procedure Coding System (HCPCS) in relation to mental health services is essential.
- Manage claims in an web-based billing and claiming environment with tasks including but not limited to accurately perform charge entry into clearinghouses and payer portals, confirming patient eligibility and plan coverage
- Research and identify CPT/HCPCS billing revenue codes and utilize electronic claim forms UB/Healthcare Financing Administration (HCFA) to bill claims
- Confirm appropriate ICD-10 diagnostic codes to ensure proper billing
- Review Explanation of Benefits (EOBs) and confirm plan requirements to ensure all collectable revenue is identified.
- Communicate with peers and supervisors to address billing and claims issues as appropriate and as needed
- Participates in internal billing audits to reduce billing errors and maximize collections
- Be available for alternative work schedules including flexibility to work within the following time slots: 8:00am – 8:00pm; occasional evening and weekend work as needed based on workload
- Generate daily batching reports based on total claims billed
- Perform other duties as assigned
- High school diploma or GED
- Minimum of three (3) years of demonstrable progressive experience in medical billing
- Demonstrated ability to enter and process minimum 200 claims per day depending upon billing system
- Must be familiar with external payer portals and clearinghouses; Navinet, Promise preferred
- Demonstrated understanding of policy deductibles, co pays, and coinsurance and out of pocket maximums
- Demonstrated understanding of billing revenue codes CPT/HCPCS and claim forms UB/HCFA
- Demonstrated knowledge of ICD-10diagnosis codes
- Demonstrated knowledge of Explanation of Benefits (EOB) interpretation and balance billing requirements
- Demonstrated extensive knowledge of medical terminology
- Demonstrated ability to work effectively as part of a team
- Demonstrated strong attention to detail
- Demonstrated strong time management and organizational skills
- Demonstrated excellent judgment with the ability to independently solve problems and make decisions with little or no need for direct supervision
- Comfortable using computer with multiple screens
- Must be familiar with patient eligibility portal, PA COMPASS preferred
- Strong analytical skills
- Ability to resolve billing issues as they occur and create lasting solutions to problems to prevent issues from occurring in the future
- Ability to work in a fast-paced environment and manage and prioritize multiple, often competing, priorities
- Must possess excellent customer interaction, collaboration, presentation, and written and verbal communication skills
- Demonstrated intermediate experience with Microsoft Office applications, including Word, Excel, and Outlook; Crystal Report writer experience preferred
- Experience using/knowledge of Electronic Health Record (EHR) / Electronic Medical Record (EMR)
Equal Opportunity Employer
Elwyn is an Equal Opportunity Employer. Elwyn does not discriminate on the basis of race, color, religion, creed, ancestry, pregnancy status, medical condition, gender, gender identity or expression, genetic information, sexual orientation or identity, age, national origin, citizenship, handicap status, marital or family status, mental or physical disability, perceived disability, military or veteran status, political activities or affiliations, or any other characteristic protected under applicable federal, state or local law, ordinance, or regulation.
What you'll do
- The Revenue Cycle Specialist is responsible for ensuring accurate claim submissions for clinical services and adhering to deadlines. This includes managing claims, confirming patient eligibility, and participating in internal billing audits.
About Elwyn
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