North Mississippi Health Services · 3 months ago
Revenue Cycle Specialist - Full Time, Days
Tupelo, MS
Full-time
Onsite
Entry, Mid Level
1+ years expNorth Mississippi Health Services is seeking a Revenue Cycle Specialist to facilitate effective Revenue Cycle flow, including bill processing, denials management, and reporting. The role requires experience in handling third-party payer interactions and involves responsibilities such as billing follow-up, denial management, and communication with various stakeholders.
Hospital & Health Care
Responsibilities
Processes Billing by receiving, interpreting, processing, and submitting through various edits to third party payors billing electronically and hard copy format
Conducts billing follow up by contacting third party payers or accessing payer websites/provider portals to determine payment expectation and resolve any problem on the claim
Facilitates information communications and processing by interpreting and processing third party payor and patient inquiries in an accurate and timely manner to expedite payment
Manages denial receivable to resolve accounts
Develops strategy for appeal, appeal follow-up and/or reprocessing accounts
Analyzes denials to determines reason they occurred
Identifies trends and reports significant and recurring issues along with possible solutions to Denials Management Supervisor and Billing Manager
Takes corrective action through systematic and procedural development to reduce or eliminate payment issues
Maintains familiarity with payer methodologies and the ability to communicate with NMHS staff
Manages paid claims to resolve underpaid accounts
Develops strategy for appeal, appeal follow-up and/or reprocessing accounts
Analyzes underpayments to determine reason they occurred
Identifies trends and reports significant and recurring issues along with possible solutions to the Denials and Underpayment manager
Professionally and effectively communicates with third party carriers, vendors, and hospital contacts to promote contractual compliance
Contacts insurance companies regarding denial, underpayments or rejection issues
Serves as liaison between payers and hospital departments/physician offices or patients in resolving denials and/or underpayment issues
Assists in preparation of monthly denial reports and other denial reports as requested
Assists in preparation of monthly variance reports and other variance reports as requested
Adheres to NMHS/NMMC Policies/Procedures/Guidelines
Complies with applicable Local/State/Federal policies/procedures/guideline/regulations/laws/statues
Qualification
Required
Bachelor's Degree in Business, coding or equivalent field
Associate's Degree Willing to consider 4 yrs Claims, Billing/Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree
High School Diploma or GED Equivalent Willing to consider 8 yrs Claims, Billing/Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree
1-3 years of work experience
Excellent analytical and problem-solving skills
Good organizational and communication (written and verbal) skills
Excellent interpersonal skills
Computer skills with strong Microsoft Office, Outlook, Third Party Payer websites
Must be able to research, analyze and communicate payer trends to identify reimbursement and training issues
Must professionally and effectively communicate with third party carriers, vendors, and hospital contacts to promote contractual compliance
Must provide input and help design payer report cards in conjunction with contracting, managed care, and other revenue cycle departments
Must serve as member of the Denials Committee
Must conduct training sessions with Billing and Follow-up staff as needed
Must have effective negotiating skills, including the ability to resolve difficult claims issues
Must be able to gather and share information with knowledge, tact, and diplomacy
Must have extensive contact with: patients, payers, physician office staff, coding staff, Credentialing, Case Management, various Department heads, and all staff within the department
Benefits
Continuing Education
403B Retirement Plan with Employer Match Contributions
Pet, Identity Theft and Legal Services Insurance
Wellness Programs and Incentives
Referral Bonuses
Employee Assistance Program
Medical Benefits
Dental Benefits
Vision Benefits
License + Certification Reimbursement
Life, Long-Term and Short-Term Disability, Group Accident, Critical Illness and Hospital Indemnity Insurance
Employee Discount Program
Early Access to Earned Wages
Tuition Assistance
Relocation Assistance
Paid Time Away
Special Employee Rates at NMMC Wellness Centers
Company
North Mississippi Health Services
North Mississippi Health Services is a large rural health care system with state-of-the-art facilities in Mississippi and Alabama.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
John West
Chief Technology Officer
Kelvin Monroe
CFO - Community Hospitals
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