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Job Summary

We are seeking a detail-oriented and experienced individual to join our team in the role of Service Line Specialist Senior - Revenue Management. The position will involve handling all aspects of patient registration, charge entry, diagnosis coding, and billing for ground ambulance claims. The ideal candidate will also be responsible for accounts receivable follow-up and handling appeal requests to ensure timely and accurate payment. Previous experience in medical billing is preferred, with a strong understanding of billing procedures, insurance processes, and claim resolution. The ability to work independently, stay organized, and manage multiple tasks efficiently is essential.

Job Duties

Provides the necessary functions to bill, collect, analyze, and adjudicate hospital and billing and collection functions for all clinical service lines. This position executes and performs programs to insure efficient operations in order to generate sufficient cash flow to support operations and strategic initiatives. In the position of Service Line Specialist Senior Revenue Management responsibilities include billing and collecting for all third party insurance payers adjustment functions, adjudicating, identifying, analyzing, reducing and resolving various revenue enhancement, and credit balance issues associated hospital accounts receivable and insuring monthly cash flow for the previously mentioned service lines. These responsibilities further include the management of a portfolio of accounts consisting of accounts per Revenue Management Service Line Specialist and/or the processing of claims.

+ Performs hospital and professional billing and collection functions within the revenue cycle to include, but not limited to hospital and professional billing and collection functions, hospital and professional secondary collections, Accounts Receivable resolution, adjustments, credit balance resolution, revenue enhancement and cash flow for the various clinical service lines.

+ Performs the above-mentioned activities of the revenue cycle to insure cost effectiveness and organizational efficiency.

+ Furthermore, this position executes these functions in regards to how their function inter-relates to the other revenue cycle functions and all of the various third party payers associated with the clinical service lines.

+ Communicates their functional activities to their leader of respective functional area and Revenue Management senior management of Geisinger as it relates to billing, insurance follow-up, cash flow, cash application, revenue enhancement, organizational profitability, customer service, accounts receivable results and revenue management service line results.

+ Works in conjunction with other areas to insure coordinated activities with respect to all revenue cycle needs.

+ Provides job specific training for all revenue management employees in regards to specific functions and communicate ongoing improvements relative to process improvement and service line development.

+ Involved, when required, in the development of various revenue management and strategic plans.

+ Develops, implements, and directs various quality initiatives to insure continuous monitoring and improvements within the revenue cycle process.

+ This includes performing overall departmental operating functions within pre-determined limits and within Freedom-To-Act guidelines to insure operational efficiencies and obtaining pre-determined performance and quality targets.

+ Facilitates of various technological initiatives in support of business process improvements with respect to all revenue cycle functions and the various service lines.

+ Assists in the recruitment, orientation, and training of new Revenue Management Specialists to further the department goals.

+ Provides analysis to supervisor and manager of trends and issues identified while performing job functions.

+ Makes recommendations to correct issues identified.

+ Implements corrective action and monitors results of the action.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. *Relevant experience may be a combination of related work experience and degree obtained (Associate’s Degree = 2 years; Bachelor’s Degree = 4 years).

Position Details

Education

High School Diploma or Equivalent (GED)- (Required), Associate's Degree- (Preferred)

Experience

Minimum of 4 years-Relevant experience* (Required)

Certification(s) and License(s)

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.