Revenue Cycle Quality Specialis

Job Title & Specialty Area: Revenue Cycle Quality Specialist

Department: Patient Fin Svcs 

Location: Dallas, TX

Shift: M-F 8A -5P

Job Type: remote

Why Children's Health?

At Children's Health, our mission is to Make Life Better for Children, and we recognize that their health plays a crucial role in achieving this goal.

Through our cutting-edge treatments and affiliation with UT Southwestern, we strive to deliver an extraordinary patient and family experience, ensuring that every moment, big or small, contributes to their overall well-being.

Our dedication to promoting children's health extends beyond our organization and encompasses the broader community. Together, we can make a significant difference in the lives of children and contribute to a brighter and healthier future for all.

Summary:
This position is responsible for reviewing and analyzing denial trends to identify root causes, while improving the accuracy and productivity of all revenue cycle systems by assisting with, facilitating, and completing operations improvement projects, monitoring, and improving the quality of the patient account integrity. Under the direction of the Manager of Revenue Cycle, the Revenue Cycle Specialist will assist with data collection, data analysis, reporting, project coordination, denial prevention, implementing processes, and communication of efforts.

Responsibilities:
* Analyzes reasons for claim denials to uncover patterns that can improve Revenue Cycle process and limit financial impact.
* Assists management in identifying payer trends, monitoring priority work queues, employee productivity and performance, authorization statistics and denial statistics as assigned.
* Identify problems, recommend training and education programs, identify process improvement opportunities, and develop other programs.
* Works with project managers and teams in implementations of new systems, system upgrades and enhancement of current system functionality, participating in any phase of large or small projects.
* Collaborate with appropriate internal and external staff members to conceptualize new procedures or programs.

WORK EXPERIENCE
* At least 2 years Demonstrated leadership in teamwork, special projects and complex assignments required
* At least 2 years Expert knowledge of all revenue cycle functions related to their area of responsibility including insurance verification, insurance authorizations, patient portion calculation and collections, account documentation, etc required
* At least 2 years job related experience required

EDUCATION
* Bachelors Degree preffered

LICENSES AND CERTIFICATIONS
* EPIC Certified-2R-EPIC Essential Epic Resolute Hospital Billing or Epic Professional Billing Certification or Epic Proficiency Exam, to be completed within 6 months of job acceptance.

A Place Where You Belong

We put our people first. We welcome, value, and respect the beliefs, identities and experiences of our patients and colleagues. We are committed to delivering culturally effective care, creating meaningful partnerships in the communities we serve, and equipping and developing our team members to make Children’s Health a place where everyone can contribute.

 Holistic Benefits – How We’ll Care for You:

· Employee portion of medical plan premiums are covered after 3 years.

· 4%-10% employee savings plan match based on tenure

· Paid Parental Leave (up to 12 weeks)

· Caregiver Leave

· Adoption and surrogacy reimbursement 

As an equal opportunity employer, Children's Health does not discriminate against employees or applicants because of race, color, religion, sex, gender identity and expression, sexual orientation, age, national origin, veteran or military status, disability, or genetic information or any other Federal or State legally-protected status or class. This applies to all aspects of the employer-employee relationship including but not limited to recruitment, hiring, promotion, transfer pay, training, discipline, workforce adjustments, termination, employee benefits, and any other employment-related activity.