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Hello, We Are ruralMED!
Join our mission of supporting rural healthcare through collaboration focused on strategically tailored services, effective leadership, and industry-specific expertise.
It is extremely difficult for Revenue Cycle professionals to find education resources within the industry, and we are seeking to close that gap with your help!
Utilizing your expertise in rural healthcare billing, you will be responsible for leading CAH & RHC billing training initiatives, helping us provide hands-on billing training, and developing accurate and professional educational materials. To make sure you stay up to date on your billing expertise, you will still perform some direct billing activities.
Join our team as a Revenue Cycle Training Specialist and serve as our expert trainer and go-to education resource to inspire medical billers today!
How This Role Makes an Impact:
- Utilizing your knowledge and skill set, you will experience the rewarding satisfaction of inspiring medical billing professionals to achieve excellence.
- You will work alongside a team of dedicated and driven experts who are passionate about helping each other to be the best at supporting rural healthcare with their revenue cycle prowess.
- Applying your problem-solving and critical thinking skills, you will be empowered to take ownership and to think outside of the box to develop accurate educational materials, processes, and workflows that continue to further enhance efficacy and accuracy.
- You will play a direct role in being a go-to expert for trainees and facilities to help them maximize their reimbursement.
What It’s Like Working at ruralMED:
- Our elite and highly skilled team are driven by delivering top-notch results and supporting each other to reach a new level of excellence while making a positive impact for our clients and rural healthcare.
- Discover flexibility and autonomy with a company that understands the true value and benefits of work-life balance.
- Personal and professional growth opportunities are encouraged, and employee engagement is not just a measurement, it is a valuable tool to achieving brilliance.
- Our core values are not only motivational, they are the standard for how we conduct and take pride in our work.
- It Begins With You: Own it.
- Pave the Way. Never Settle.
- Be Thoughtful. Be Transparent. Be Extraordinary.
- Work Fearlessly. Celebrate the Wins.
- Capitalize Our Strengths. Achieve Excellence.
- Learn more about our team: https://ruralrevcycle.com/join-our-team/
How to Succeed in this Role:
- Excellent Analytical, Critical Thinking, Problem-Solving, and Adaptation skills.
- Ability to take direction and work independently.
- Strong communication and collaboration skills.
- Possess knowledge and previous experience (5 years) in Critical Access Hospital (CAH) and Rural Health Clinic (RHC) billing.
- Thrive in a fast-paced atmosphere and be able to flex and adjust to the highest priorities.
- Character Traits: Solution-Based, Highly Motivated, Achiever, Positive, Genuine, Driven, Self-Disciplined, Knowledge-Seeking, Responsible.
Title: Revenue Cycle Training Specialist
Department: Revenue Cycle
The Revenue Cycle Training Specialist will be responsible for leading billing training initiatives within their assigned clientele. Serves as an expert trainer and educational resource for client’s employed billers and ruralMED billers working within assigned client. They will provide hands on billing training and develop accurate and professional educational materials. The Training Specialist will also be expected to perform a required number of direct billing activities to maintain current billing expertise. Advanced knowledge and previous experience in Critical Access Hospital and Rural Health Clinic billing is required, as ruralMED serves primarily hospitals and clinics within rural locations.
Education and/or Experience:
• High School Diploma is required.
• Five (5) years of rural health (CAH & RHC) medical billing experience required
• Experience with Cerner or Meditech required
General Requirements/Job Duties:
To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Typical functions of this position may include:
- Conducts virtual training sessions for client billing staff and/or ruralMED billing staff
- Training sessions to include individual account review within the client’s EHR, clearinghouse edit resolution, payor portal utilization, payor policy education, and general billing education
- Responsible for development, delivery, and optimization of training materials such as lesson plans, handouts and slide presentations as needed.
- Conduct routine reviews to identify non-adherence to process, identify opportunities for process improvement or re-education to improve overall department performance
- Performs regular audits to identify areas of opportunity and re-education opportunities
- Makes recommendations to improve client service based upon training observations
- Exemplifies extensive knowledge of the Revenue Cycle with specialization in rural health billing, follow-up, and the account resolution process to include, but not limited to: claims submission, acceptance, and adjudication, transaction reviews, adjustment posting, identification of patient responsibility, etc.
- Fosters an atmosphere of trust and credibility through professional training approach
- Possesses ability to professionally communicate (in all forms) with payer and client resources such as: on-site visits, website, e-mail, telephone, customer service departments, etc.
- Monitors team performance and success against pre-defined key performance indicators (i.e. productivity, quality, etc.)
- Other duties as assigned
- Responsible for the evaluation, coordination, development, and implementation of all billing processes
- Processes electronic and paper claims in a timely and accurate manner. Ensures edits to electronic claims meet and satisfy billing compliance guidelines for electronic submission.
- Resolves clearinghouse claim errors and payer rejections
- Performs follow-up processes on denied or unpaid insurance claims. Researches, identifies, and rectifies any circumstances affecting payment and takes steps to get claim paid utilizing websites, phone calls to the payers, and/or internal inquiry
- Resolves issues in a timely manner, including requests for medical records, coordination of benefit issues, and requests for more information, by coordinating with the responsible department
- Reviews remaining balances on accounts after insurance has paid to ensure the account was processed appropriately and performs the next appropriate action
- Resolves overpaid accounts by performing payment review to determine if posting corrections are required or/and a refund is due to the insurance company
- Maintains an account aging process for tracking aging accounts
- Processes adjustments or corrections to patient account(s) according to policy guidelines.
- Resolve denied claims utilizing the payer’s designated reconsideration and appeal process
- Accurately and thoroughly documents all actions performed on an account in the appropriate area of the EHR system
- Monitors third-party contract payment arrangements, both private and governmental to ensure accurate reimbursement and performs reimbursement analysis as necessary
- Maintains current knowledge of billing and reimbursement rules as designated by the Centers of Medicare and Medicaid Services (CMS), Medicaid Managed Care, and other payers.
- Keeps up to date with regulations that affect collection of receivables; monitors third-party contract payment arrangements, both private and governmental.
- Communicates issues to management, including payer, system, or escalated account issues.
- Maintains proficient knowledge of EHR, clearinghouse, and payer systems, as well as any other systems, required for performing required job duties.
- Other duties as assigned.
Required Knowledge, Skills and Abilities:
- Experience with Cerner or Meditech required
- Knowledge of medical terminology and/or insurance terminology is required.
- Proficient with Microsoft Office
• Will have access to confidential information abiding by the organizations privacy policies and regulations concerning this information.
• General office equipment to include: fax, copier, computer, printer, etc.
Patient Age Groups Served:
Essential Work Environment & Physical Requirements:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.