Revenue Cycle Associate

6 months ago

Regina, Canada St. John's Riverside Hospital Full time

Overview

St. John's Riverside Hospital is a leader in providing the highest quality, compassionate health care utilizing the latest, state-of-the-art medical technology. Serving the Westchester community from Yonkers to the river town communities of Hastings-on-Hudson, Ardsley, Dobbs Ferry and Irvington, St. John's Riverside has been and continues to be a unique and comprehensive network of medical professionals dedicated to a tradition of service that spans generations.

St. John’s has been an integral part of the community since the 1890's and its’ commitment to provide the community with the most advanced medical services available continues to be the hospitals’ vision, mission and value. St. John's Riverside Hospital built itself around an early foundation of nursing and community service. In 1894, the Cochran School of Nursing, the oldest hospital-based school of nursing in the metropolitan area, was founded, thus making the St. John's Nursing Staff more than just the backbone of the hospital, but the heart and soul. St. John’s dedicated nurses give superior attention to those who need it most with a strong emphasis on patient and family-focused nursing care.

St. John’s Riverside Hospital staff is committed to making life better for all patients. The hospital continues to elevate the services provided with the goal of increasing the quality of life for all who entrust St. John's Riverside Hospital to their care.

Personalized care together with advanced technology is what it means to be Community Strong

Responsibilities

The Revenue Cycle Associate (RCA) will assist and support the operations of the revenue cycle process for the St. John’s Medical Group. The RCA collaborates with the revenue team to ensure efficiency of services and implementation of practices to promote positive financial performance.

The Revenue Cycle Associate flexes between roles to assist with tasks in the areas of credentialing, pre-authorization and billing as assigned

Billing assist with implementation of charge capture/billing processes to optimize revenue provide timely and accurate retrieval of information for outsourcing to the billing company collaborate with Providers regarding accurate documentation to promote timely billing

assist with review of outstanding pending cases to assess for accuracy, missing information, and editsensure proper documentation is retrieved and sent for required billing and reviewsknowledgeable in billing practices including standard codes sets (HCPCS, CPTS & ICD coding, UB 04 & 1500 forms, 837 and 835 requirements) maintain current working knowledge of Medicare and Medicaid Pre-authorization assist with obtaining prior authorizations as assigned verify insurance and registration data in EMR system

ensure insurance is re-verified and properly updated in the system. follow up with insurance companies to ensure authorization is received 7 to 15 days prior to the visit/procedurecommunicate outcome of pre-auth requests to Supervisor

as necessary, communicate insurance decision to patient and/or Provider officeas assigned, conduct appeals, and facilitate peer reviews with the physicianreview patient account files and ensure accuracy and timely submission of all documents

identify concerns related to pre-auths and reports same to Supervisor pursue all concerns/discrepancies in a timely manner to ensure pre-auths are completed scan and maintain all follow up documentation in the patient’s account file

General Answer the telephone in a polite manner. Communicate information to the appropriate personnel.

Demonstrate flexibility in work schedule and in a respectful and positive working relationship with insurance companies, co-workers, and other departments.

Assist in special projects and other duties as assigned. Abide by all HIPAA policies and procedures as they pertain to Patient Health Information.

Assist with completion of medical record requests and/or scanning as needed. Participate in educational/training as required.

Perform other related duties as assigned by to St. John’s Riverside Hospital attendance policy. Regular attendance and timeliness are required. This includes, but is not limited to:at workstation prepared for work by the start of shift;

taking the time allowed for breaks; remaining at work for entire shift, unless excused by a supervisor;leaving promptly at the end of shift, unless advance permission from supervisor to work extra hours has been provided and

personally, notifying Supervisor or another member of management if either absent or tardy, unless a verifiable emergency makes it impossible for you to do so.

Qualifications

Preferred: Three years of experience in medical office setting with focus revenue activities Associate Degree Medical Coding Certificate Proficient in Microsoft OfficeExcellent written and oral communication skills.Exceptional attention to detail and accuracy.

Experience in customer service in medical setting required. Occasionally lifts up to 10 pounds Stand and sits 5 to 8 hours accordingly to a workdayPhone use: 50% of shift. Computer use: 5-6 hours per shift.

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