Specialist Comercial Revenue Cycle

We are recruiting for a mission-driven Specialist Comercial Revenue Cycle to join our team!

We're with you for life's journey. At Denver Health, purpose isn't just something we believe in-it's something we live every day, for life's journey.

Our Values

Respect | Belonging | Accountability | Transparency

Department
Billing and Collections

Job Summary

Under general supervision, the Specialist ensures optimal reimbursement for hospital or provider billing on inpatient and outpatient accounts. Provides customer service, billing, timely follow-up, cash application processes, reconciling payer remittance, denial management and appeal functions for claims to government or grant funded programs, worker's compensation, commercial insurance. Provides financial guidance on self-pay accounts. Interprets explanation of benefits. Investigates delinquent accounts for legal liability. Acts as liaison support between the Hospital and Physician Business Services departments and third-party payers and other Denver Health departments. Utilizes various software applications and information systems to perform work processes.

Essential Functions:

• Completes claims submissions, performs review of accounts, ensure that work performed is accurate and complete. Consistently documents contact with debtor/insurance and/or any other content to the account using appropriate methods. Reviews account information and makes necessary changes. Researches, corrects, and resubmits claims within the mandated time frames to avoid loss of revenue. Initiates collections by contacting third party payer/debtor or designated representative. (40%)
• Returns assignments within the appropriate timeframe and with suggestions for resolution or process improvement. Completes worklists as assigned. Work product is consistently of high quality. Staff QA'd weekly and must be at 97% or higher. (20%)
• Uses billing systems efficiently and appropriately. Follows and understands actions needed to correctly effect patient accounts with the Siemens Invision system. Utilizes the imaging system to perform needed account research; able to scan, import and export if needed. Uses eligibility software to ensure the correct payer is billed. (15%)
• Processes accounts transactions accurately that involve transfer of charges, combining accounts, or manual adjustments. (10%)
• Processes and responds to incoming correspondence from insurance carriers, patients, and other Denver Health departments to move the accounts toward resolution. (10%)
• Identifies and communications existing or potential problems to supervisor in a timely manner. Offers constructive actions in problem resolution. (5%)

• High School Diploma or GED Required

• 1-3 years Experience in a hospital or clinic revenue cycle setting Required
  
• 1-3 years
  

• Knowledge and understanding of insurance benefit plans and explanation of benefits.
• Have current knowledge of regulatory requirements and codes.
• Skill sets to include 10-key by touch, typing a minimum of 25 words per minute (WPM) and, basic skills in word processing and spreadsheet applications.
• Ability to prioritize work activities with minimal supervision, in an individual and team setting.
• Strong written and verbal communication skills, analytical thinking, high level of computer accuracy, and organization and problem solving skills.
• Ability to utilize various software applications and information systems to perform work processes.
• Ability to adapt easily to change.

• Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
  
• 100% paid parental leave up to 6 weeks
  
• Immediate eligibility for retirement plans with employer contribution up to 9.5%
  
• Generous medical, dental, vision plans in addition to employer paid disability and life insurance.
  
• Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center
  
• Free RTD EcoPass (public transportation)
  
• Childcare discount programs & exclusive perks on large brands, travel, and more
  
• Tuition reimbursement & assistance
  
• Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways
  
• Professional clinical advancement program & shared governance
  
• Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
  
• National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer