Revenue Cycle Specialist II- MUST RESIDE IN COLORADO

Job DetailsJob Location: Main Office - Denver, CO 80231Position Type: Full TimeSalary Range: $19.29 - $20.50 HourlyWhy work at Rocky Mountain Human Services?

You will have the opportunity to contribute to an organization that is dedicated to embracing the power of community to support individuals and families in creating their future.

RMHS provides great benefits such as

Employer paid medical options, dental, and vision benefits
Generous paid time off such as vacation, sick, personal, and holidays
Life and disability insurance
Tuition reimbursement (full-time employees only)
Mileage reimbursement
403(B) with company match
Flex Spending Account for Health and Dependent Care Costs
Employee assistance program

Position Purpose

The Billing and Receivable Specialist works with different programs within RMHS and revenue cycle department in order to consistently submit claims to insurance payers and to ensure that they are paid as per contract terms. This position is also responsible for communication with internal and external customers and health service providers.

Essential Duties

Performs insurance verifications, prior authorizations and re-authorizations as required by funding source
Responsible for submitting claims and ensuring follow up on outstanding claims
Ensures information obtained is complete and accurate to request appropriate authorizations
Collaborates with internal departments and external providers on utilization management of authorizations
Acquires and shares knowledge of authorization requirements for all funding sources for behavioral health in the State of Colorado (commercial and waiver)
Ensures all services have authorizations properly documented in all software applications necessary and communicated to all programs within RMHS
Ensures up-to-date documentation in billing software
Ensures compliance with all federal, state, local and internal policies and procedures
Performs other duties as assigned with a comprehensive understanding of all functions on the entire revenue cycle

QualificationsKnowledge, Skills and Abilities

Knowledge of healthcare billing and reimbursement strategies.
Ability to effectively communicate both orally and in writing.
Demonstrates the ability to plan and organize work, coordinate with others, use time productively and establish appropriate priorities.
Provide excellent customer service to both internal and external customers.
Attention to detail is a must for researching and interpretation.
Ability to support HIPAA privacy rules and maintain strict confidentiality.
Ability to function as a team player.
Ability to adapt to change and be flexible.

Essential Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Actively communicate with customers and stakeholders.
Works with customers, staff, stakeholders.
Ability to meet/work with staff, stakeholders in a variety of settings.
Attends staff, team and department meetings.
Attends in-services, staffing and other meetings with supervisor’s approval. May be appointed to committees.
Develops and maintains records, plans and reports.
Lift and/or carry 20 lbs.
Sit, stand, and walk for reasonable periods of time.
Maintains prompt and regular attendance.
Performs related work as assigned.

Qualifications

1-2 years of relevant experience in finance/healthcare, medical billing & reimbursement.
Experience with State and Federal (Medicare, Medicaid) and private insurance billing systems.
Proficiency in Microsoft products including Word and Excel.

Preferred Qualifications

Previous experience working with healthcare insurance, billing (therapy services, behavioral health, Medicaid HCBS Waiver, Early Intervention), medical coding, denial management, and insurance reimbursement.
Experience with medical billing software.
Excellent communication skills (written, verbal).
Excellent customer service skills.

Rocky Mountain Human Services is an Equal Opportunity Employer and is committed to racial, ethnic and cultural diversity and the goals of the Americans with Disabilities Act.