*Revenue Cycle Specialist/RAC Coordinator

Company: Community Memorial Health System
Location: Ventura
Posted on: May 4, 2021

Job Description:

Overview

Community Memorial Health System is a community-owned, not-for-profit organization that consists of two hospitals and 15+ community clinics including family-practice, urgent care, our residency program, and several specialties within Ventura County. We are fully accredited by Det Norske Veritas (DNV), licensed by the California Department of Public Health and ISO 9001:2015 certified.

Located close to the beach, just 60 miles north of Los Angeles, is Community Memorial Hospital. Our 242-bed, acute care facility, is committed to providing quality patient care in an environment that promotes clinical excellence and innovative leadership.

Ojai Valley Community Hospital, an affiliate of Community Memorial Hospital is a 25-bed general acute care facility designated as a Critical Access Hospital with a distinct part 66 bed skilled nursing facility. OVCH provides inpatient, outpatient, and skilled nursing services for mostly primary and secondary care needs. In addition, we operate a 24-hour standby emergency department.

CMHS offers some of the best benefits in the industry, along with great career choices, training, and leadership development. At our facility, our employees share their enthusiasm for life as well as for helping others. As you balance your work life with your other passions, we're there for you every step of the way.

CMHS offers excellent benefits, such as Medical, Dental, Vision, Life, and AD&D insurance. We also offer a comprehensive 403(b) retirement plan, flexible spending accounts, paid time off, and a variety of other great benefits.

If you are interested in joining teams that meld quality care and compassion to create an environment of excellence, please take a moment to discover more about what it's like to work at Community Memorial Health System.

"We are an AA/EEO/Veterans/Disabled Employer"

Responsibilities

Position Overview:

The Revenue Cycle Specialist is responsible for accurate and timely review of third party payer accounts for claims rejection, bill hold edits, denials, and charge capture issues impacting timely filing and denials at CMHS. Collaborates closely with clinical departments and provides education to reduce billing edits, ensure accurate charge capture, and reduce denial related issues related to CMHS claims and billing.

Qualifications

Required:

• High school diploma or general education degree (GED)
• Minimum three (3) years' experience in hospital billing, including federal and state claims submission, and electronic claims submission
• Technical knowledge of correct coding principles of CPT/HCPCS modifier selection and UB-04 revenue codes
• Experience with medical records and chart-to- charge audit review for charge capturing accuracy
• Knowledge of Medicare, Medicaid, Medicaid OPPS reimbursement, and other 3rd party billing rules/coverage
• Excellent written, organizational, analytical, motivational and critical thinking skills
• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
• Ability to review medical accounts with numerical problems to calculate interest, patient liability, self pay accounts, and observation time
• Competency in Word and Excel to document and report issues
• Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form
• Basic clerical skills

Preferred:

• Certified Coding Specialist (CCS); Certified Professional Coder (CPC), or Registered Health Information Technician (RHIT)
• Ability to execute strategy and communicate knowledge of business processes to drive success within Revenue Cycle Management
• Ability to use Excel spreadsheet, PowerPoint, and MS Visio, and Project Management

Keywords: Community Memorial Health System, Ventura , *Revenue Cycle Specialist/RAC Coordinator, Other , Ventura, California