Job Description

Department: Clinic Enterprise Salary: 43,000-48,900 Description: The Revenue Cycle Specialist provides high level expertise and support to the Revenue Cycle Division of UH Health Family Care Center through ensuring account resolution and reconciliation of aged patient account receivables. The incumbent works in partnership with the Revenue Cycle Leadership team and serves as a resource for staff support, innovation, and process improvements. This position works in a collaborative team environment to foster value to internal and external customers. This involves performing collection activities related to follow up and account resolution including communications to payors, patients, clients, and other reimbursement vendors. The Revenue Cycle Specialist supports patient financial clearance by determining applicant eligibility and benefits of third party reimbursement, assists patients in filling coverage gaps, and handling inquiries from patients.

1. Analyzes aged open patient accounts which may include technical and at risk denials.
2. Demonstrates knowledge of standard billing forms and filing requirements.
3. Maintains active working knowledge of government and non-governmental regulations as it pertains to claims submission.
4. Identifies and communicates trends creating barriers to timely account resolution.
5. Identifies and resolves underpayments and/or overpayments.
6. Responds to various types of account inquires through written, verbal, or electronic correspondence.
7. Appropriately documents follow up efforts in appropriate EMR.
8. Provides effective collection efforts while ensuring the successful recovery of accounts in accordance with state and federal guidelines.
9. Makes outbound communication ( phone calls, portal messages, letters, etc.) to insurance companies and patients in order to follow up on unpaid, denied, or rejected claims, as needed.
10. Analyzes open patient responsibility balances and deploys techniques to reduce patient balances.
11. Reviews and works any credit balances to determine the appropriate party refunds as appropriate.
12. Assists patients in enrolling in assistance coverage assistance programs to help eliminate barriers to care ( Sliding Fee Scale, Grants, Medicaid, and/or Marketplace). 1

3. Effectively and accurately reviews patient?s third party coverage benefits to determine patient financial responsibility and plan requirements.

1. Counsels patients on matters related to insurance benefits and payment options.
2. Performs other special projects as required when assigned.

MQ: Education: Requires a basic knowledge of grammar, spelling, punctuation and simple mathematical functions like percentages, ratios, etc. as might normally be acquired through attainment of a high school diploma or GED. Experience: Requires a minimum of three (3) years of directly job-related experience. Additional job Posting Information:

• Department is willing to accept education in lieu of experience.
• Department is willing to accept experience in lieu of education.

All positions at the University of Houston-System are security sensitive and will require a criminal history check. The University of Houston System and its universities are an Equal Opportunity Institution.

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