• Responsible for the collection of outstanding balances from commercial insurance and self-pay payers • Continuously improving revenue cycle processes • Manage client business accounts, policy applications and collection activities • Work eight-hour shift five days a week and be available to work additional hours when necessary • Overtime may be required • Responsible for overall credit and collections activities of client accounts • Maintain integrity of accounts receivable ledger, including aged receivable monitoring on an ongoing basis • Responsible for maintaining current knowledge of revenue components including benefit plans, contract terms and rates and billing forms and codes • Check status of claims through use of telephone, websites and/or other means available • Document adjustments needed to client accounts • Identify & recommend adjustments needed to client accounts • Pursue collection activities and follow up for balances outside of established norms • Coordinate collection activities with outside agencies, including court appearances, as needed • Maintain consistency in application of credit policies throughout the revenue cycle – from admission to final account resolution • Perform secure handling of cardholder data, including encryption, data storage limitations, and adherence to security protocols • Participate in mandatory Payment Card Industry (PCI) training, access controls, and regular security assessments, all aligned with PCI Data Security Standard (DSS) guidelines • Provide feedback & education to departments/internal customers with regards to issues that impact revenue flow and or capture • Provide appropriate documentation and reports designed to assist in fiscal management of the agency • Serve as a member of the Revenue Cycle Team and participate in all team meetings and activities • Understand and comply with all the principles established by the Rosecrance Corporate Compliance Program and Code of Conduct • Perform all responsibilities in compliance with the mission, vision, values, and expectations of Rosecrance • Deliver exceptional customer service consistently to every customer

• The Revenue Cycle Specialist is responsible for reviewing and processing claims in various stages of the revenue cycle in a timely and compliant manner • Monitor overall client performance, identify potential loss or delay in revenue to ensure maximized reimbursement for assigned clients • Initiate timely and proactive communication to payers to identify deficiencies and provide appropriate feedback to operational staff in order to resolve and prevent issues • Prioritize, process, and delegate correspondence, rejections, denials, appeals, static claims, and all other follow up on claims in accordance with compliance standards and payer and client specifications • Work independently to define problems, identify causes, and initiate steps necessary for resolution in a timely manner • Regularly meet, and effectively communicate with, Supervisor Claims Management, onshore and/or offshore team members to ensure highest level of reimbursement is achieved • Holistically approach client performance by utilizing big picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow though • Monitor and measure client performance outcomes in comparison to client commitments; identify barriers, seek and suggest solutions when desired outcomes are not achieved • Stay abreast of industry changes and regulations to ensure adherence and proactive preparedness • Exhibit strong customer service skills to build and maintain internal and external relationships in order to best address client needs.

• Provides billing support to Patient Financial Services. • Performs payment posting to support revenue cycle operations. • Identifies denials for follow up and performs account follow up activities. • Updates information on accounts and organizes work in a timely manner. • Participates in department meetings and provides feedback to management.

• Performs retrospective coding review of denied charges for physician services. • Reviews medical records for completeness and accuracy to ensure documentation supports the services billed and all documentation standards are met for billing. • Make corrections to charges when necessary. • Analyze for invalid denial trends, payer specific carrier submission requirements & system optimization. • Performs extensive follow-up to investigate and resolve payment denial trends. • Resolves outstanding accounts utilizing ancillary applications and websites as tools to retrieve medical documentation. • Researches and interprets payer contract terms and compiles necessary supporting documentation templates for appeals. • Ensures denial reviews are conducted in a timely manner. • Maintains up-to-date policies and procedures and knowledge related to managed care and third party payors. • Participates in annual and on-going mandatory compliance training. • Fulfills Continuing Education Units necessary to maintain certification status. • Assists in training current and new employees on the use of systems and departmental policies and procedures. • Performs other related duties as assigned.