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Revenue Cycle Specialist

1 month ago

Collingwood Ontario LM, Simcoe region, Canada Emory Healthcare Full time

Overview

Be inspired. Be rewarded. Belong. At Emory Healthcare.

At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:

  • Comprehensive health benefits that start day 1
  • Student Loan Repayment Assistance & Reimbursement Programs
  • Family-focused benefits
  • Wellness incentives
  • Ongoing mentorship, development, and leadership programs
  • And more

Knowledge of front office to include insurance verification, understanding of insurance benefits explanation and prior authorization experience.

Description

Revenue Cycle Specialist I

  • Collects and follows up on all accounts assigned prior to, during or after admission and discharge.
  • Identifies patients who require financial counseling intervention; provides information regarding resources for patients who need financial help after discharge and/or during collections and follow up activities.
  • Maintains thorough understanding of insurance, payment reimbursement, account reconciliation, referrals, authorizations, and account follow-up to secure reimbursement of claims.
  • Provides support to leadership facilitating quality improvement by reporting problems, concerns, and opportunities for increased revenue and decreased denials through the quality assurance process.
  • This position requires heavy phone and computer usage, and a detailed knowledge of applicable EMRs, patient accounts, payer, and financial tools.
  • Specialist is required to review, analyze and understand the Managed Care Contracts and various aspects of patient care to maximize reimbursement.
  • This includes but is not limited to transplants, hospice, infusions, rehab and Center of Excellence patients.
  • Knowledge of payer requirements including pre-cert requirements, splitting of claims, analyzing payments, researching complex payment variances are critical for patient and/or account resolutions.
MINIMUM QUALIFICATIONS:
  • Bachelors Degree with two years of relevant experience; OR any combination of equivalent education and experience. Certified Patient Accounts Representative (CPAR) and/or Certified Patient Financial Counselor (CFC).
  • If not certified, must be obtained within eighteen months of employment.

JOIN OUR TEAM TODAY Emory Healthcare (EHC), part of Emory University (EUV), is the most comprehensive academic health system in Georgia and the first and only in Georgia with a Magnet designated ambulatory practice. We are made up of 11 hospitals-4 Magnet designated, the Emory Clinic, and more than 425 provider locations. The Emory Healthcare Network, established in 2011, is the largest clinically integrated network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties.

Additional Details

Supporting a diverse, equitable and inclusive culture. Emory Healthcare (EHC) is dedicated to providing equal opportunities and access to all individuals regardless of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression and/or veteran's status. EHC does not discriminate on the basis of any factor stated above or prohibited under applicable law. EHC respects, values, and celebrates the unique perspectives and backgrounds of all individuals. EHC aspires to create an environment of collaboration and true belonging for all our patients and team members. Emory Healthcare (EHC) is committed to achieving a diverse workforce through equal opportunity and nondiscrimination policy in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training.

ACCOMMODATIONS: EHC will provide reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Diversity, Equity, and Inclusion.

PHYSICAL REQUIREMENTS (MediumMax 25lbs):

up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure, Bio-hazardous waste, Chemicals/gases/fumes/vapors, Communicable diseases, Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

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