[Hiring] Revenue Cycle Specialist @ArchWell Health

Role Description

The Revenue Cycle Specialist provides support of all aspects of Revenue Cycle Services and is responsible for supporting the efficiency and effectiveness of revenue cycle operations including vendor and MA plan partner collaboration to meet service level agreements and key performance indicators. This position reports to the Revenue Cycle Director and will be responsible for supporting the day-to-day revenue cycle operations. This role will collaborate with our clinical, operations and IT teams to drive results.

• Support rapidly growing outsourced billing and coding teams, and identify ideal operating process flows as needed for scalability and optimization.
• Assist in developing strong internal processes and documented workflows in support of the revenue cycle, and ensure appropriate integration with field operations.
• Continually seek ways to improve the delivery and support of revenue cycle activities and provide recommendations for changes to proactively identify process improvement and eliminate barriers to success.
• Provide eligibility and insurance verification support to centers.
• Investigate and resolve issues related to patient coverage, effective dates, and missing enrollment information by contacting insurance companies, patients, and other departments. Maintain accurate patient demographic and insurance data in EHR.
• Confirm member co-pays, deductibles, coinsurance are accurately captured and collected.
• Support all aspects of coding and billing to ensure legal and compliance standards.
• Conduct internal audits of billing and coding practices. Provide regular cadence reporting to compliance.
• Ensure adherence to CMS and payer specific regulations.
• Assist in building strong relationships with key stakeholders including finance and accounting, IT and field clinical operations.
• Assist in the development of training materials and deliver in person training as needed to our field personnel as we open new centers.
• Occasional travel will be required (5-10%).

Qualifications

• Deep understanding of revenue cycle functions and requirements in a complex, multi-state setting.
• Possess excellent communication skills, both written and oral.
• Proven performance results, decision making and judgement.
• Experience with external vendors and outsourced billing staff.
• Extensive knowledge of eClinicalWorks strongly preferred.

Requirements

• Associate’s degree required.
• 3+ years of revenue cycle experience in physician office setting.
• Coding certification (CPC, COC, CCS, CCA, CPB, CBCS) required or completed within 6 months of hire.
• Experience with capitated reimbursement models strongly preferred.

Benefits

• Embodies and serves as a role model of ArchWell Health’s Values:
• Be compassionate
• Strive for excellence
• Earn trust
• Show respect
• Stay resilient
• Always do the right thing

Company Description

At ArchWell Health, we’re creating a community of caring designed to help our members stay healthy and engaged. By focusing on a strong provider-patient relationship, routine wellness, and staying active, our members enjoy a higher level of care and better quality of life after the age of 60. Everything we do is for seniors. We believe seniors should be heard, listened to, and given ample time by their physicians to live well later in life.

Our value-based care model is designed to prevent illnesses while keeping members healthy and happy in every aspect of their life. We deliver best-in-class primary care at comfortable, accessible neighborhood centers where older adults can feel at home and become part of a vibrant, wellness-focused community. We’re passionate about caring for older adults and united by the belief that caring has the power to change everything for our members.

ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.