The Revenue Cycle Specialist reports to the Revenue Cycle Manager and will interface with Finance, Operations and payers to maximize revenues. The Revenue Cycle Specialist will coordinate with all related parties in order to submit claims and data collection to meet the needs of the organization. This job description does not list all the duties of the job. You may be asked by Manager to perform other duties. 

• Review Program Billing Sheets/EHR Systems to ensure compliance with Medicaid, Medicare and MCO policies and procedures
• Follow-up with Programs for any incomplete claim/encounter before billing submission
• Responsible for creating Medicaid /MCO claims to submit through e-Paces/third party billing
• Submit vouchers to State for BOCF billing on a monthly basis
• Upload remittance and book related journal entries on a weekly basis
• Reconcile claim denial reports on weekly basis, prepare appeals and implementation of programs to prevent future billing issues.
• Review remittance advice, work with related departments and health care providers to get claims processed and paid.
• Prepare and reconcile monthly billing reports against general ledger
• Generate the open issue report for discussion and follow up
• Liaise with other departments and third party vendors regarding monthly billing, collection and compliance.
• Work proactively with the billing team, to identify opportunities for productivity improvements
• Assists in preparing for annual internal, external and regulatory financial audits
• Perform routine and ad-hoc financial Analyses, and other duties as assigned.

• High School Diploma required. Bachelor’s Degree in finance or accounting (Preferred)
• Basic computer skills, Microsoft Excel, Outlook and Word, and accounting knowledge
• Experience with Medicare, Medicaid, Managed Care plans and commercial payers required
• Aptitude for using a fast-paced proactive vs. reactive approach to manage competing priorities.
• Excellent communication, interpersonal and decision making skills
• Knowledge of Fund EZ, Awards, CORE, NAV and e-Paces is a plus

S:US IS AN EQUAL OPPORTUNITY EMPLOYER 

Join a team of employees who care about the wellbeing of others. We believe in fostering a culture built on our core values: respect, integrity, support, maximizing individual potential and continuous quality improvement. From health and wellness resources to generous PTO, professional development, and more, explore all that we offer on our Benefits Page and see how S:US invests in you. 

We believe in fostering a culture built on our core values: respect, integrity, support, maximizing individual potential and continuous quality improvement.  

All qualified applicants will receive consideration for employment without regard to race, color, religion, disability, age, sexual orientation, national origin, veteran status, or genetic information and including all other statuses protected by Federal, State and Local laws. S:US is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities, including allowance of the use of services animals. To request reasonable accommodation or if you believe such a request was improperly handled or denied, contact the Leave Team at MyMedicalLeave@sus.org.