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HEDIS Revenue Cycle Management Specialist
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Position Summary:
The Revenue Cycle HEDIS Specialist will be responsible for building and maintaining collaborative and productive relationships within the organization relating to revenue cycle management, managing revenue cycle projects, driving performance in operations related to reimbursement and providing direction and oversight of processes impacting cash collections.
Job Responsibilities:
Serves as a source of knowledge for the designated revenue cycle function for our clinical division while going through and reviewing patient charts notes and pulling out the specific pertinent information for each patients packet.
Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement for the designated revenue cycle function.
Responsible for developing appropriate workflows and tracking for the designated revenue cycle function.
Establishes an ongoing working relationship with other departments impacting revenue cycle performance.
Works closely with various vendor operations teams (Prior authorization, Claims and Appeals) to oversee operations activity that directly impacts the revenue cycle to accurately process actions in a timely manner for optimal reimbursement.
Tracks outcomes of payment resolution, appeals, and negotiated claims to ensure goals are met.
Leads weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities.
By continually reviewing and monitoring billing and coding changes, researches, evaluates, and interprets guidance from a variety of sources to determine departmental actions.
Coordinates with Management to ensure thorough understanding of trends/issues affecting revenue cycle performance.
Develops goals and metrics to link department and revenue cycle initiatives with the organization's strategy.
Develops, manages and monitors successful completion of implementation and project plans.
Acts as an educator on performance improvement requirements in operations and methodologies to related teams and departments.
Continuously seeks new and creative technologies that help identify and guide improvement opportunities that align with overall company success
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
The Revenue Cycle HEDIS Specialist will be responsible for building and maintaining collaborative and productive relationships within the organization relating to revenue cycle management, managing revenue cycle projects, driving performance in operations related to reimbursement and providing direction and oversight of processes impacting cash collections.
Job Responsibilities:
Serves as a source of knowledge for the designated revenue cycle function for our clinical division while going through and reviewing patient charts notes and pulling out the specific pertinent information for each patients packet.
Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement for the designated revenue cycle function.
Responsible for developing appropriate workflows and tracking for the designated revenue cycle function.
Establishes an ongoing working relationship with other departments impacting revenue cycle performance.
Works closely with various vendor operations teams (Prior authorization, Claims and Appeals) to oversee operations activity that directly impacts the revenue cycle to accurately process actions in a timely manner for optimal reimbursement.
Tracks outcomes of payment resolution, appeals, and negotiated claims to ensure goals are met.
Leads weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities.
By continually reviewing and monitoring billing and coding changes, researches, evaluates, and interprets guidance from a variety of sources to determine departmental actions.
Coordinates with Management to ensure thorough understanding of trends/issues affecting revenue cycle performance.
Develops goals and metrics to link department and revenue cycle initiatives with the organization's strategy.
Develops, manages and monitors successful completion of implementation and project plans.
Acts as an educator on performance improvement requirements in operations and methodologies to related teams and departments.
Continuously seeks new and creative technologies that help identify and guide improvement opportunities that align with overall company success
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
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