Specialist Comercial Revenue Cycle at Denver Health

Denver, Colorado, United States -

Full Time

Start Date

Immediate

Expiry Date

20 Feb, 26

Salary

31.5

Posted On

22 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Customer Service, Billing, Cash Application, Denial Management, Claims Processing, Insurance Knowledge, Analytical Thinking, Problem Solving, Communication Skills, Computer Accuracy, Organizational Skills, Software Applications, Regulatory Knowledge, Time Management, Teamwork, Adaptability

Industry

Hospitals and Health Care

Description

We are recruiting for a motivated Specialist Comercial Revenue Cycle to join our team! We are here for life’s journey. Where is your life journey taking you? Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all: Humanity in action, Triumph in hardship, Transformation in health. Department Billing and Collections Job Summary Under general supervision, the Specialist ensures optimal reimbursement for hospital or provider billing on inpatient and outpatient accounts. Provides customer service, billing, timely follow-up, cash application processes, reconciling payer remittance, denial management and appeal functions for claims to government or grant funded programs, worker's compensation, commercial insurance. Provides financial guidance on self-pay accounts. Interprets explanation of benefits. Investigates delinquent accounts for legal liability. Acts as liaison support between the Hospital and Physician Business Services departments and third-party payers and other Denver Health departments. Utilizes various software applications and information systems to perform work processes. Essential Functions: Completes claims submissions, performs review of accounts, ensure that work performed is accurate and complete. Consistently documents contact with debtor/insurance and/or any other content to the account using appropriate methods. Reviews account information and makes necessary changes. Researches, corrects, and resubmits claims within the mandated time frames to avoid loss of revenue. Initiates collections by contacting third party payer/debtor or designated representative. (40%) Returns assignments within the appropriate timeframe and with suggestions for resolution or process improvement. Completes worklists as assigned. Work product is consistently of high quality. Staff QA’d weekly and must be at 97% or higher. (20%) Uses billing systems efficiently and appropriately. Follows and understands actions needed to correctly effect patient accounts with the Siemens Invision system. Utilizes the imaging system to perform needed account research; able to scan, import and export if needed. Uses eligibility software to ensure the correct payer is billed. (15%) Processes accounts transactions accurately that involve transfer of charges, combining accounts, or manual adjustments. (10%) Processes and responds to incoming correspondence from insurance carriers, patients, and other Denver Health departments to move the accounts toward resolution. (10%) Identifies and communications existing or potential problems to supervisor in a timely manner. Offers constructive actions in problem resolution. (5%) Education: High School Diploma or GED Required Work Experience: 1-3 years Experience in a hospital or clinic revenue cycle setting Required 1-3 years Knowledge, Skills and Abilities: Knowledge and understanding of insurance benefit plans and explanation of benefits. Have current knowledge of regulatory requirements and codes. Skill sets to include 10-key by touch, typing a minimum of 25 words per minute (WPM) and, basic skills in word processing and spreadsheet applications. Ability to prioritize work activities with minimal supervision, in an individual and team setting. Strong written and verbal communication skills, analytical thinking, high level of computer accuracy, and organization and problem solving skills. Ability to utilize various software applications and information systems to perform work processes. Ability to adapt easily to change. Shift Days (United States of America) Work Type Regular Salary $22.50 - $31.50 / hr Benefits Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans Free RTD EcoPass (public transportation) On-site employee fitness center and wellness classes Childcare discount programs & exclusive perks on large brands, travel, and more Tuition reimbursement & assistance Education & development opportunities including career pathways and coaching Professional clinical advancement program & shared governance Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer Our Values Respect Belonging Accountability Transparency All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver’s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation. As Colorado’s primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year. Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer. Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. Applicants will be considered until the position is filled. Denver Health was founded as City Hospital in 1860 to serve the health care needs of the rapidly developing city of Denver. Since then, we have grown alongside the community to become a complete health care system, proudly providing care for all residents -- at every point in their lives. We believe healthy people are the foundation of a vibrant community, and Denver Health has been treating and healing the people of Denver for more than 160 years. Today, Denver Health delivers preventive, primary and acute care services. We are committed to making our community a healthy place to live, work and raise a family. You’ll see that commitment in the programs we offer, through the care we provide and in our determination to achieve continuous improvement so our community always has the best care available. As a comprehensive, integrated organization, we provide hospital and emergency care to the public, regardless of ability to pay. This integration promotes continuity of care for each patient and assures health care that is delivered in the most efficient, cost-effective setting. We care for: thirty-three percent of Denver's population annually; Denver Health sees nearly 1,200,000 total patient visits annually. one in three Denver-area children each year. the needs of special populations such as the poor, uninsured, pregnant teens, persons addicted to alcohol and other substances, victims of violence and the homeless. As Colorado's primary safety-net institution, Denver Health has provided uncompensated care and serves as a model for other safety net institutions across the nation.

Responsibilities

The Specialist ensures optimal reimbursement for hospital or provider billing on inpatient and outpatient accounts. This includes customer service, billing, timely follow-up, cash application processes, and denial management.