POSITION SUMMARY:

The Revenue Cycle Specialist is responsible for the full-cycle medical billing process, including eligibility verification, claims generation, eligibility verification, payment posting, denial resolution and follow-up, and responding to billing inquiries. While each Specialist may have a primary focus area (such as front-end processes like eligibility and claim creation or back-end processes like denials and follow-up), both roles are expected to be cross-trained and capable of performing all core billing functions to ensure operational coverage and flexibility.

QUALIFICATIONS AND SKILL REQUIREMENTS:

• Excellent communication and interpersonal skills
• Attention to detail and organizational skills.
• Ability to work harmoniously with a broad range of staff, volunteers, and the community as a representative of Navian Hawaii.
• Demonstrates good judgment in seeking and accepting guidance, facilitates clear and honest communication with other team members.
• Consistently demonstrates ethical conduct and judgment that is in harmony with the mission and values of Navian Hawaii

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

• High School Diploma or GED equivalent required.
• 1–3 years of experience in healthcare billing and coding preferred; hospice specific billing is a plus.
• Experience in nonprofit healthcare setting is a plus.
• Proficient in the use of MS Word, Excel, Outlook, and overall computer skills. GL software knowledge preferred.
• Is knowledgeable of and maintains HIPAA standards of privacy and confidentiality.

CREDENTIALING & OTHER DUTIES

• Assist in enrolling new providers with payers and maintaining active status.
• Maintain provider access in systems such as Hoku and PECOS to support accurate billing.
• Assist in creating and updating internal billing process documentation.
• Participate in team meetings to share insights, updates, and process improvements.
• Perform other billing-related duties as assigned.