Revenue Cycle Support Specialist

Job description

Description
POSITION TITLE: Revenue Cycle Support Specialist
RESPONSIBLE TO: Revenue Cycle Manager
FLSA STATUS: Non – Exempt
Purpose of the Position: The Revenue Cycle Support Specialist provides operational support across Revenue Cycle, Front Office, and Credentialing functions to ensure efficient patient access, billing operations, and provider enrollment activities.
Requirements
QUALIFICATIONS:
• High School diploma or GED is required; Associate Degree in Business Administration, Healthcare Administration, or related field preferred.
• Minimum two years of experience in healthcare administration, medical office operations, medical billing and customer service, credentialing, or related healthcare experience setting.
• Knowledge of medical insurance plans including Medicare, Medicaid, commercial insurance, and managed care organizations.
• Knowledge of and experience working with insurance enrollment systems including PECOS and CAQH is preferred.
• Knowledge of and experience working with Epic preferred.
• Knowledge of FQHC billing practices including PPS and wraparound claims preferred.
• Knowledge of computers and computer systems including Microsoft Applications.
• Knowledge of HIPAA regulations and healthcare confidentiality requirements.

RESPONSIBILITIES:
Revenue Cycle:
• Respond promptly and professionally to customer service inquiries via phone and portal.
• Research and resolve basic billing, payment, and account concerns.
• Manage incoming mail and return mail.
• Collaborate with internal staff and external contractor to resolve billing and customer service issues.
• Utilize Electronic Health Record (EHR) system to update patient information, process billing data, and support provider and staff needs.
• Maintain accurate documentation of all interactions and resolutions in compliance with organizational policies.

Credentialing:
• Collaborate with providers, internal staff and external contractors, on all enrollment, credentialing and provider contracting.
• Act as primary point of contact for external contractor and operations team for initial provider onboarding.
• Support CAQH profile management and ensure provider information remains current and accurate.
• Maintain current knowledge of all verification procedures, data entry procedures and report development and production.
• Process and track provider terminations and disenrollment.
• Utilize advanced problem-solving skills to resolve issues and conflicts that may arise.
• Maintain confidentiality of provider information and comply with regulatory policies and procedures.

Front Office Operations Support:
• Provide support and education regarding registration, scheduling, insurance verification, eligibility, and sliding fee processes.
• Provide support, education and validation via audit of the sliding fee discount program.
• Provide support and education regarding new VFHC revenue initiatives.

Perform other duties as assigned.
Physical Requirements:
• Must be able to lift 25 lbs.
• Continuous sitting, standing, walking.
• Correctable vision and hearing.
• The ability to communicate information and ideas so others will understand. Must be able to exchange accurate information in these situations.
• The ideal candidate must be able to complete all physical requirements of the job with or without a reasonable accommodation.