Position Goal

Assist Employees and Management in Main and Satellite Clinics by promoting Revenue Cycle Education and training as needed. Ensures compliance, tracks and monitors education and training effectiveness on a continuous basis to ensure desired outcome is achieved. Position is extension of HEAT training team.

Position Responsibilities

• Development of Revenue Cycle training objectives consistently for Hughston employees as assigned (all locations—Billing (to inc DME, imaging/ancillary), clinical coding scope of duties)
• Creates necessary content for Educational material for staff; videos, written materials, training classes, etc….update content as necessary to stay abreast of an ever changing environment.
• Develop and conduct/ensure monthly revenue cycle education to all assigned staff members. (all new revenue cycle related initiatives). Ensures existing training up to standards (gap analysis).
• Using report data available; drill down to location level/target audience for training to ensure fundamental levels of understanding. Uses denial or Athena data/audits to identify training and training opportunities. Work with PRD to determine root cause analysis of denied claims.
• Develop content and track the completion of employee 90 day training checklist and compencies related to revenue cycle activities.
• Develops & tracks training metrics to determine if initial training (and follow up) training is effective. Includes on-going auditing as a tool.
• Tracks and monitors on going training and education for operational effectiveness. Reports to appropriate operational officer for any recommendations or adjustments needed/implements accordingly.
• Reports on Revenue Cycle training/activity to Hughston administration as required.
• Educate and personnel whose duties include revenue cycle functions in accordance with clinic, governmental and other regulatory standards as applicable. (State and Federal billing cycle law/procedures; WC, etc…)
• Monitors compliance; ensures education is timely and effective regarding new compliance standards as they develop. Performs targeted audits.
• Responsible for direct (on-site) communication to management and applicable staff members in regards to billing/coding procedures, training, etc…
• Understand the process of a productive revenue cycle; assesses workflow and patterns to recommend changes as determined to gain maximum efficiency. Understands current management system functionality regarding assigned position scope.
• Assist training and education of new staff members. (all clinics; existing and new)
• Responsible for understanding the complete revenue cycle workflow of our EMR system.
• Act as a resource for administrative staff, revenue staff, clinical staff and new employees.
• Meet with Practice Administrators at least quarterly to review operational issues and discuss strategic plans.
• Collaborate with Revenue Cycle Integrity team to identify areas for targeted education.
• Recommend and provide input on revenue cycle related Policies and Procedures.
• Participate in professional development activities and maintain professional affiliations to include attending conferences, workshops, maintaining certifications, etc…
• Assign and assist employees and managers with Athena certifications as applicable. Track and monitor compliance standards.
• Maintain patient and staff confidentiality at all times.

Experience:

Required:

• Five years revenue cycle related job experience. or
• Three years revenue cycle job experience with related degree.

Education:

Required:

• High school diploma or equivalent required.
• Certified CPC; or credentialed by AHIMA required.

Preferred:

• Bachelor’s level degree in related field preferred.

CRCR and/or CPAR certifications preferred.

Special Qualifications:

Required:

• Must be able to work independently and multi-task. Must be extremely detailed.
• Knowledge of ICD 10/CPT medical terminology.
• Must be able to demonstrate good professional judgement in performance of daily duties.
• Must be able to travel to satellite clinics as necessary to support job function.
• Must be able to work irregular hours. Position may require availability for after-hour calls to manage situations as needed.
• Current Motor Vehicle Record (MVR) must be in good standing. Must have valid drivers license in good standing. (MVR’s ran annually—requires good standing)
• Effective communication skills both written and oral required.
• Must have good working knowledge of training and compliance principles in role. Must understand and communicate technical componets of the revenue cycle to others.
• Must demonstrate effective use of insurance claim processing, posting, modifier use, understanding EOB’s, navigation of payor sites, HCFA/UB, determining payments, deductibles.
• Must complete assigned Athena certification within the first 90 days.

Candidates who are hired are eligible to receive a Healthcare Financial Management Association (HFMA) membership and access to certification trainings.

The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, Hughston Medical, Hughston Orthopaedics Trauma, Hughston Orthopaedics Southeast and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.