Revenue Cycle Management Specialist-Medicine

The Revenue Cycle Specialist (RCMS) is a multi-disciplinary role, which combines work from 3 key revenue cycle functions within the Department of Medicine’s Billing Office (DOMBO): coding/auditing, charge entry, and payment posting. The RCMS reports to the Manager, Accounts Receivable, who collaborates with the Manager, Charge Entry and Supervisor, Coding to determine work allocation to ensure that he RCMS is focusing on the greatest need that supports initiatives within the Department of Medicine and DOMBO. The RCMS is responsible for abstracting and coding notes/encounters, entering patient demographics, insurance information, professional charges and posting and reconciling payments into the professional billing system for services rendered by Department of Medicine (DOM) Physicians and Advanced Practice Providers (APP). The RCMS ensures that all information entered in the professional fee billing system is precise and accurate; and other duties as assigned.

ESSENTIAL FUNCTIONS

• Works across 3-4 clinical disciplines and prioritizes areas of greatest need/focus. Ability to navigate complex disciplines with multiple locations, billing areas, and/or special workflows.
• Selects the appropriate procedural and diagnostic code based on provider documentation, utilizing HIPAA Standardized Code Set and applying CMS/payor guidelines.
• Ensures that teaching physician documentation and billing requirements are met and are clearly reflected.
• Review provider coding and provide training and feedback on coding questions and issues.
• Collaborates with Accounts Receivable team with denials and charge correction requests as needed.

EDUCATION and/or EXPERIENCE

• High school diploma or general education degree (GED) preferred
• Certified Professional Coder (CPC) or Certified Professional Coder-Apprentice (CPC-A)
• Two or more years of experience in a medical billing office
• Experience with resolution of claims edits preferred
• PC proficiency, to include but not limited to, MS Office software
• Knowledge of Athena/GE/IDX, EPIC, or similar computerized billing system
• Knowledge of payers in specialty
• Knowledge of ICD-10 and CPT coding
• Understanding of: FSC's used in Athena/GE/IDX system, contractual requirements for the job; importance of compliance with all government regulations regarding billing.

Total Rewards
The referenced base salary range represents the low and high end of University of Maryland’s Faculty Physician’s Inc. salary range for this position. Some candidates will not be eligible for the upper end of the salary range. Exact salary will ultimately depend on multiple factors, which may include the successful candidate's geographic location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/training and other qualifications.  University of Maryland Faculty Physician’s Inc. offers a total rewards package that supports our employees' health, life, career and retirement. More information can be found here: https://www.umfpi.org/jobs/summary-employee-benefits