Revenue Cycle Specialist

Do you envision finding a meaningful role with an inclusive and compassionate team? At Children's Mercy, we believe in making a difference in the lives of all children and shining a light of hope to the patients and families we serve. Our employees make the difference, which is why we have been recognized by U.S. News & World Report as a top pediatric hospital, for eleven consecutive years.

Children's Mercy is in the heart of Kansas City - a metro abounding in cultural experiences, vibrant communities and thriving businesses. This is where our patients and families live, work and play. This is a community that has embraced our hospital and we strive to say thanks by giving back. As a leader in children's health, we engage in meaningful programs and partnerships throughout the region so that we can improve the lives of children beyond the walls of our hospital.

This position provides analytical support to Analyst II-Customer Service, Customer Service Supervisor, Coordinator, Managers and Senior Management. It serves as a knowledgeable resource within the Customer Service Unit. This position interacts with internal and external customers to provide information in response to inquiries about patient services per departmental policy, and handles parent concerns. This position participates in special projects and will assist with departmental processes. Responsibilities of this position include ensuring consistencies are followed between co-workers as well as able to provide valuable information on job qualities and efficiencies. This position aids in the training of new employees. Maintains working knowledge of reimbursement methodologies while maintaining a high level of integrity, respect and confidentiality for our patients, families and co-workers. This position also adheres to upholding Shared Values and Service Excellence of the Hospital.

At Children's Mercy, we are committed to ensuring that everyone feels welcomed within our walls. A successful candidate for this position will join us as we strive to create a workplace that reflects the community we serve, as well as our core values of kindness, curiosity, inclusion, team and integrity.

Additionally, it's important to us that we remain transparent with all potential job candidates. Because we value the safety of the patients and families we serve, as well as the Children's Mercy staff, we want to let you know that the seasonal influenza vaccine is a condition of employment for all employees in our organization. New employees must be willing to be vaccinated if found non-immune to measles, mumps, rubella (MMR) and chicken pox (varicella) and/or without evidence of tetanus, diphtheria, acellular pertussis (Tdap) vaccination since 2005. If you are selected for this position, you will be asked to supply your immunization records as proof of vaccination. If you and have any concerns about receiving these vaccines, medical and/or religious exemptions can be further discussed with Human Resources.

May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans accurately and in a timely manner, meeting goals for work quality and productivity. Coordinates with other staff members and physician office staff as necessary to ensure correct processing.
1. As assigned, reconciles, balances, and pursue account balances and payments, as well as denials. This may involve working with payor remittances, facility contracts, payor customer service, provider representatives, spreadsheets, and the company's collection/self-pay policies to ensure maximum reimbursement.
2. May be tasked with researching payments, denials, and/or accounts to identify short/overpayments, contract discrepancies, incorrect financial classifications, and internal/external errors. Make denial appeals and corrections as necessary.
3. Builds strong working relationships with assigned business units, hospital departments, or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and resolve problems.
4. Responds to incoming calls and makes outbound calls as required to resolve billing, payment, and accounting issues, offering assistance and excellent customer service to patients, their families, providers, and other internal and external customers.
5. Works as a member of the patient financial services team to achieve goals related to days and amounts of outstanding accounts, aiming to reduce Accounts Receivable balances.
6. Uses systems to document information, provide statistical data, prepare issue lists, and communicate accurately with payors.
7. Works independently under general supervision, following defined standards and procedures. Reports to the Supervisor or Manager. Utilizes critical thinking skills to solve problems and reconcile accounts promptly. External customers include all hospital patients, their families, and all third-party payers. Internal customers include facility medical records, patient financial services staff, attorneys, and central services staff members.
8. Analyzes, develops and prepares reports for leadership utilized for operations and identifying trends; utilizes knowledge of all aspects of the revenue cycle to make sound decisions as it relates to the remediation of claims.
9. Participates in regular meetings with payor representatives, clinical departments or hospital facilities; studies data, identifies discrepancy patterns and presents solutions; analyzes clinical or payor data to make informed decisions on the remediation of patient accounts.
10. Provides informal guidance, support and training to team members to aid in achieving revenue management's operational objectives.
11. Acts as a knowledge resource for departmental staff as well as for other internal CMH departments pertaining to area of responsibility. Assists management in troubleshooting credit balance system issues, concerns and trends.
12. Performs other responsibilities as assigned.

• Associate's Degree and 3-5 years experience 3 years prior experience in an insurance follow up background in a healthcare, patient accounting industry. or
• HS diploma or equivalent and 5-7 years experience 5 years prior experience in an insurance follow up background in a healthcare, patient accounting industry accepted in lieu of an associate's degree

The benefits plans at Children's Mercy are one of many reasons we are recognized as one of the best places to work in Kansas City. Our plans are designed to meet the changing needs of our employees and their families.

Our pay ranges are market competitive. The pay range for this job begins at $20.66/hr, but your offer will be determined based on your education and experience.

This position is entirely remote or work-from-home. The person hired must live in the Kansas City metro area and may attend on-site meetings, as scheduled.

#LI-Remote

Children's Mercy hires individuals based on their job skills, expertise and ability to maintain professional relationships with fellow employees, patients, parents and visitors. A personal interview, formal education and training, previous work experience, references and a criminal background investigation are all factors used to select the best candidates. The hospital does not discriminate against prospective or current employees based on the race, color, religion, sex, national origin, age, disability, creed, genetic information, sexual orientation, gender identity or expression, ancestry or veteran status. A drug screen will be performed upon hire. Children's Mercy is smoke and tobacco free.

CM is committed to creating a workforce that supports the diverse backgrounds of our patients and families. We know that our greatest strengths come from the people who make up our team, so we hire great people from a wide variety of backgrounds, not just because it's the right thing to do, but because it makes our hospital stronger and our patient care more compassionate.

If you share our values and our enthusiasm for service, you will find a home at CM. In recruiting for our team, we welcome the unique contributions that you can bring, including education, ideas, culture, and beliefs.