Revenue Cycle Specialist - Plastics (Medical Center)

Overview

At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect revenue cycle support to the Revenue Cycle Managers. It is responsible for the timely coordination and completion of regulatory and / or revenue-enhancing special projects as identified by the Revenue Cycle Managers. In addition, the Revenue Cycle Specialist is responsible for resolving all outstanding third-party primary and secondary insurance claims for professional services. This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the professional fee environment. This role is also responsible servicing as the subject matter expert in account follow-up. Also is responsible for providing information regarding complex denial trends for future prevention. The individual who holds this position exemplifies the mission, vision and values and acts in accordance with all HMH and PO CBO policies and procedures, including complying with The Houston Methodist Experience Service Standards.

Houston Methodist Standard

PATIENT AGE GROUP(S) AND POPULATION(S) SERVED

Refer to departmental "Scope of Service" and "Provision of Care" plans, as applicable, for description of primary age groups and populations served by this job for the respective HM entity.

HOUSTON METHODIST EXPERIENCE EXPECTATIONS

• Provide personalized care and service by consistently demonstrating our I CARE values :

INTEGRITY : We are honest and ethical in all we say and do.

Responsibilities

PEOPLE ESSENTIAL FUNCTIONS

SERVICE ESSENTIAL FUNCTIONS

QUALITY / SAFETY ESSENTIAL FUNCTIONS

FINANCE ESSENTIAL FUNCTIONS

GROWTH / INNOVATION ESSENTIAL FUNCTIONS

This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business / job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.

Qualifications

EDUCATION

WORK EXPERIENCE

License / Certification

LICENSES AND CERTIFICATIONS - REQUIRED

LICENSES AND CERTIFICATIONS - PREFERRED

KSA / Supplemental Data

KNOWLEDGE, SKILLS, AND ABILITIES

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

ON-CALL

TRAVEL

Company Profile

Houston Methodist Specialty Physician Group - As one of the nation's leading hospitals and academic medical centers Houston Methodist has brought together some of the nation's leading experts in multiple specialties to serve our patients. As part of Houston Methodist Specialty Physician Group (HMSPG), these specialists not only provide excellent clinical care, but are on the forefront of research, developing leading-edge technologies and treatments, and teaching the medical pioneers of tomorrow. This combination of clinical service, research and academics ensures patients have access to the latest in treatments and technologies while providing the best in comprehensive patient care. Established as a non-profit corporation and certified by the Texas State Board of Medical Examiners, HMSPG enables physicians to maintain autonomy with respect to their clinical practice while growing their practice within an academic environment.