The Revenue Cycle Specialist reports to the Revenue Cycle Manager and will interface with Finance, Operations and payers to maximize revenues. The Revenue Cycle Specialist will coordinate with all related parties in order to submit claims and data collection to meet the needs of the organization. This job description does not list all the duties of the job. You may be asked by Manager to perform other duties.
- Review Program Billing Sheets/EHR Systems to ensure compliance with Medicaid, Medicare and MCO policies and procedures
- Follow-up with Programs for any incomplete claim/encounter before billing submission
- Responsible for creating Medicaid /MCO claims to submit through e-Paces/third party billing
- Submit vouchers to State for BOCF billing on a monthly basis
- Upload remittance and book related journal entries on a weekly basis
- Reconcile claim denial reports on weekly basis, prepare appeals and implementation of programs to prevent future billing issues.
- Review remittance advice, work with related departments and health care providers to get claims processed and paid.
- Prepare and reconcile monthly billing reports against general ledger
- Generate the open issue report for discussion and follow up
- Liaise with other departments and third party vendors regarding monthly billing, collection and compliance.
- Work proactively with the billing team, to identify opportunities for productivity improvements
- Assists in preparing for annual internal, external and regulatory financial audits
- Perform routine and ad-hoc financial Analyses, and other duties as assigned.
Benefits Overview: We offer attractive compensation with comprehensive benefits including: Medical/Dental/Prescription/Vision/Life Insurance;403(b); Credit Union; FSAs; Short-and-Long-Term Disability; Transportation Plan; Generous Paid Vacations and Holidays
- High School Diploma required. Bachelor’s Degree in finance or accounting (Preferred)
- Basic computer skills, Microsoft Excel, Outlook and Word, and accounting knowledge
- Experience with Medicare, Medicaid, Managed Care plans and commercial payers required
- Aptitude for using a fast-paced proactive vs. reactive approach to manage competing priorities.
- Excellent communication, interpersonal and decision making skills
- Knowledge of Fund EZ, Awards, CORE, NAV and e-Paces is a plus
SUS IS AN EQUAL OPPORTUNITY EMPLOYER
Services for the UnderServed (S:US) believes every New Yorker has the right to lead a life of purpose. Since 1978, S:US has been turning this belief into reality by advocating for people with life circumstances marked by homelessness, intellectual/developmental disability, behavioral health and addiction challenges, poverty, criminal justice involvement, and trauma. Our dedicated workforce of 2,400 provides services and supports to transform the lives of 35,000 individuals and families in New York City and Long Island.