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Revenue Cycle Management Associate

Company: Primary Health Solutions
Location: Hamilton
Posted on: July 31, 2022

Job Description:

Description:
JOB TITLE: Revenue Cycle Management (RCM) Associate
DEPARTMENT: Administration
REPORTS TO: Revenue Cycle Manager
STATUS: Non-Exempt
SUMMARY:

The RCM Associate is responsible for provider onboarding and annual enrollment and credentialing according to HRSA and FTCA guidelines.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

This job description reflects management's assignment of essential functions. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.

BOARD CREDENTIALING:

Completes credentialing checklists for providers and clinical staff in a timely manner before the board cycle.
Retains detailed and accurate records in a standardized format for all clinical staff.
Maintains knowledge of all HRSA and FTCA credentialing and privileging requirements.
Tracks license and certification expirations for all providers and clinical staff to ensure timely renewals.
Assists providers and other staff as necessary with the completion of applications and credentialing paperwork, including gathering appropriate signatures.
Works collaboratively with HR to ensure necessary documents are collected during orientation and before, if applicable.
Monitors Provider CME expenditures by maintaining Excel spreadsheet.
Regularly updates and distributes Provider Roster
Maintain confidentiality of provider and staff information.

OTHER:

Prepare and deliver reports, recommendations, or alternatives that address existing and potential areas for improvement in the organization. Report examples: OB activity (detail and RVUs), virtual and telehealth encounters, no show rates, pharmacist encounters.
Generate daily, weekly, monthly, and year-to-date volume reports by service and provider.
Prepares dental RVU reports for Dental Quality Committee.
Maintains payer contract files.
Uploads daily reports to billing company.
Collaborates with team members to resolve inconsistencies and errors.
Is cross trained for, and serves as back-up to, Payer Credentialing Specialist.

SUPERVISORY RESPONSIBILITIES:

This job has no direct reports.

CONFIDENTIALITY:

Maintains confidentiality of all personnel, medical, financial, or other sensitive materials and information in printed, electronic or verbal form, which may jeopardize the privacy of patients and/or employees. Accesses and uses the minimum necessary patient identifiable information to perform job responsibilities and only for authorized purposes.

Requirements:
QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION AND/OR EXPERIENCE:

High school diploma or GED minimum. Associate degree or higher preferred.
2 years or more relevant credentialing experience

LANGUAGE SKILLS:

Ability to read, comprehend and interpret documents with attention to detail. Ability to write routine reports and correspondence. Excellent verbal and written communication skills including emails and phone calls.

REASONING ABILITY:

Ability to analyze details. Ability to understand systems and processes from a high level and step-by-step view. Detail oriented with above average organizational skills. Plans and prioritizes to meet deadlines.

COMPUTER SKILLS:

To perform this job successfully, an individual should have the ability to gain knowledge of current practice management systems, intranet, and electronic medical record. The individual should have full working knowledge of Microsoft Office (including Excel and Word) DocuSign and the Internet.

CERTIFICATES, LICENSES, REGISTRATIONS:

Certified Provider Credentialing Specialist (CPCS) preferred.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to sit and stoop, kneel, crouch, or crawl. The employee must regularly lift and /or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duty of this Job, the employee is occasionally exposed to fumes or airborne particles, toxic or caustic chemicals and risk of radiation. The noise level in the work environment is usually moderate.
PI187110437

Keywords: Primary Health Solutions, Hamilton , Revenue Cycle Management Associate, Executive , Hamilton, Ohio

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