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Company

Seneca Holdings · 6 hours ago

Revenue Cycle Specialist

United States

Full-time

Remote

Mid Level

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BankingFinancial Services

No H1B

U.S. Citizen Only

Security Clearance Required

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Responsibilities

Support the DHA-project with extensive SME (Subject Matter Expert) knowledge in MHS GENESIS Revenue Cycle including all Charge Services.

Supports the system’s ability to provide integrated solutions and services to optimize business workflows, and control cost to collect across acute, ambulatory, specialty, and inpatient venues.

Support an assessment of the current state and provide a foundation for developing a roadmap and plan for the development of the RI functionality in DHA.

Analyze and reconcile suspended charges and Discharged Not Final Billed (DNFB). Based on the analysis, use a sprint framework to identify and prioritize proposed projects and reduce the backlog.

Support a roadmap to pilot and then roll out a scalable enterprise Revenue Cycle program.

Help design and implement a portfolio of Revenue Cycle decision-support tools focused on the most important Key Performance Indicators for fiscal health.

Support and leverage business process re-engineering efforts to achieve standardization within all Revenue Cycle areas.

Apply principles and practices in Revenue Cycle management, such as charge capture, coding, billing, reimbursement, denial management, and compliance.

Training support/collaboration on end user training materials and workflow collateral

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Revenue Cycle ManagementMHS GENESISElectronic Health RecordData AnalysisMicrosoft Office 365Oracle/CernerBillingCodingProcess ImprovementKey Performance IndicatorsFavorable Suitability AdjudicationMilitary Health System ExperienceData Analytics Tools

Required

Requires a Bachelor’s degree in a clinical or healthcare-related field. An Associate degree combined with an additional five (5) years of Revenue Cycle experience may be substituted for the Bachelor’s degree.

Can achieve a Favorable Suitability Adjudication, based on a T1 background investigation.

Due to the nature of the government contract requirements and/or clearance requirements, US citizenship is required.

Substantial knowledge and a working understanding of Revenue Cycle concepts, business processes, and/or operations within the healthcare industry.

Ability to analyze and interpret complex data, processes, and reports related to revenue cycle and integrity and identify and resolve related issues and problems.

Ability to collaborate and communicate effectively with team members, clients, business partners, and other various stakeholders involved in revenue cycle.

Ability to succeed in a dynamic team environment and produce deliverables in tight timeframes.

Microsoft Office 365 proficiency (Excel, Word, PowerPoint).

Excellent oral, written, and interpersonal skills.

Preferred

Must have a Favorable Suitability Adjudication, based on a current T1 background investigation.

Possess a DHA issued Common Access Card (CAC).

Substantial experience within the Military Health System (MHS) environment and requisite knowledge of revenue cycle operations.

Ability to use various software applications and tools to perform Revenue Cycle functions, such as Electronic Health Record systems (Oracle/Cerner Patient Accounting Module (CPAM)), billing/claim solutions/systems (Electronic Claims Clearinghouse (SSI), 3M 360 Encompass Institutional & Professional Coding, Claim Scrubber Edits (Alpha ii), Dentrix Billing, Patient Statements/Letters (RevSpring)), and data analytics tools/repositories (Excel, Power BI, SAS, Tableau, HealtheAnalytics).

Knowledge of MHS billing and coding policies and regulations.

Experience with the Oracle/Cerner Electronic Health Record (EHR) (MHS GENESIS), Patient Accounting Module (CPAM) and reports: HealtheAnalytics, Discern Reporting Portal, and Lights On Network, ideally in the MHS environment.

Experience in the following MHS GENESIS roles: CPA: Accounting/Biller/Poster, CPA: Management, CS: Charge Analyst Local, and Scheduling Basic.