Role Description
The Healthcare Data Validation & Ingest Specialist (Medical RCM) is responsible for managing and monitoring the intake of billing files and patient records from multiple sources, including email submissions and portal downloads. This role ensures timely and accurate importing of data into the system, validates file integrity, sorts and indexes records, and processes case logs and surgery schedules. The position requires strong organizational skills, attention to detail, and the ability to work under tight deadlines.
Essential Functions and Tasks
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File Intake and Monitoring:
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Monitor and manage files received through Intake Billing and email submissions.
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Pull patient records and billing files from designated portals.
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Track and log all incoming files to ensure completeness and accuracy.
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Sorting and Organization:
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Sort files by facility, Date of Service (DOS), and other required criteria.
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Organize and maintain structured file storage for easy retrieval.
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Data Import and Indexing:
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Import files into the system following established protocols.
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Index additional records to the correct patient account to maintain data integrity.
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Validate data formatting and resolve discrepancies before ingestion.
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Case Log and Surgery Schedule Processing:
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Process case logs and surgery schedules accurately and in a timely manner.
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Ensure all related documentation is properly linked to patient accounts.
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Communication and Coordination:
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Collaborate with internal teams to address missing or incorrect files.
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Escalate issues promptly to ensure timely resolution.
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Compliance and Documentation:
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Maintain accurate records of all imported files and related activities.
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Ensure compliance with HIPAA and organizational data security standards.
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Reporting and Analysis:
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Generate reports on file intake status and data ingestion performance.
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Provide insights to improve efficiency and reduce errors in the import process.
Qualifications
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Bachelorβs degree in Healthcare Administration, Finance, Accounting, Business Management, or a related field preferred.
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Equivalent work experience in healthcare revenue cycle or billing may be considered in lieu of a degree.
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Minimum 1β2 years of experience in medical billing, charge posting, or healthcare revenue cycle operations.
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Hands-on experience with batch processing, visit list management, and charge log review.
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Familiarity with healthcare systems, electronic health records (EHR), and reporting tools (e.g., concurrency reports, cube data).
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Experience working with month-end closing schedules and meeting strict deadlines.
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Knowledge of HIPAA compliance and data integrity standards.
Knowledge, Skills, and Abilities
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Ability to read, understand, and apply state/federal laws, regulations, and policies.
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Ability to communicate with diverse personalities in a tactful, mature, and professional manner.
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Ability to remain flexible and work within a collaborative and fast-paced environment.
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Basic use of computer, telephone, internet, copier, fax, and scanner.
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Basic touch 10 key skills.
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Basic Math skills.
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Understand and comply with company policies and procedures.
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Strong oral, written, and interpersonal communication skills.
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Strong time management and organizational skills.
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Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills.
Compensation
Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons. This position is also eligible for a discretionary incentive bonus in accordance with company policies.