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Tampa General Hospital · 13 hours ago

Revenue Cycle Specialist Sr - Med Onc Support Services

Tampa, FL

Full-time

Hybrid

Mid, Senior Level

$53K/yr - $53K/yr

3+ years exp

Tampa General Hospital is seeking a Revenue Cycle Specialist Sr to support their Radiation Oncology department. The role involves managing revenue cycle processes, ensuring accurate billing, and optimizing reimbursement while providing guidance and training to staff.

Health CareHospitalMedicalNon Profit

Growth Opportunities

Responsibilities

Oversees the daily workflow to ensure all front-end revenue cycle processes are performed professionally and accurately

Supervises and oversees training of support staff, including Front Desk Specialist and Financial Specialist, through all workflow processes to ensure staff successfully understands their roles and associated responsibilities. Completes staff training, maintaining productivity standards and ensuring that established goals and objectives are met or exceeded on a consistent basis

Serves as a leader/trainer for other staff regarding clinical programs and policies to promote service and compliance consistency

Illustrate excellent knowledge of healthcare industry regarding the revenue cycle, coding, claims, and state insurance laws. Educate and communicate revenue cycle/financial information to patients, payers, providers, co-workers, managers, and others as necessary to ensure accurate processes

Maintains functional and efficient billing / charging on a daily basis. Maintains billing log system to reach maximum reimbursement through accurate and timely billing procedures

Verifies insurance benefits and compensation coverages by contacting insurance companies and employers to determine necessity for advance deposits, co-payments and deductibles. Identifies payor needs and information deficits and coordinates the provision of information to facilitate reimbursement

Develops and maintains financial references, including guidelines for reimbursement, state and federal regulations, payor-specific reimbursement policies. Develops and maintains TGH Radiation Oncology/Proton Center Reimbursement policies, procedures and resource material references. Updates third party payor reimbursement needs

Establishes and maintains regular contacts with agencies offering financial aid; develops efficient processes/procedures for candidates to follow to complete the application process. Facilitates efficient communications for timely responses

Assists patients with inquiries regarding financial/insurance issues through data collection, assessment and follow-up activities. Identifies appropriate resources to handle problems and complaints effectively

Develops computerized database reports specific to Proton Center patients, including proton treatment tracking spreadsheet

Reviews Documentation Requests sent by TGH Claims Follow-up team and provides requested information such as, but not limited to missing referrals, diagnoses, procedure codes, and other pertinent information required for claim submission

Assists with the rejection reports; research reasons for denials, gathers requested data/documents to provide information to PUBS for claims re-submittal. Assist with the oversight of divisional charge rejection reports for the billing service. Acts as a liaison between the department and the billing office to ensure timeliness of turnaround for charge rejections

Maintains functional and efficient billing / charging on a daily basis. Maintains billing log system to reach maximum reimbursement through accurate and timely billing procedures

Actively communicate and present pertinent information to various audiences, particularly revenue cycle, practice and finance leadership. In addition, communication with senior leaders and formal TGH committees is expected. Uses reporting tools to understand risks and opportunities with significant impact to TGH Radiation Oncology and conveys these along with impact and recommendations to leadership

Is recognized and relied upon as a subject matter expert in multiple revenue cycle areas who can recognize problems, formulate solutions and recommend changes in revenue, process efficiency and compliance areas. Responsible for the development, implementation and maintenance of complex programs and tools; the interpretation and implementation of new solutions; and identifies opportunities and recommends options for increasing financial margins

Performs other duties and responsibilities that are appropriate to the position and area. The above responsibilities are a general description of the level and nature of the work assigned to this classification and are not to be considered as all-inclusive

Qualification

Revenue cycle managementMedical billingInsurance verificationFinancial analysisHealthcare regulationsInterpersonal skillsCommunication skillsProblem-solving skillsTeam collaboration

Required

AA in Business, Finance, Accounting, or related field, or equivalent education and experience

A minimum of 3-5 years of experience working within a medical group billing department in a healthcare setting

Excellent interpersonal & communication skills; high level of competence in customer relations in a professional environment; ability to prioritize, organize work and be self-directed; ability to work as a member of a team; ability to work in stressful situations; good problem-solving skills