SOS is proud to be the largest Federally Qualified Health Center in Orange County to combine wrap-around social services with health care. We have 6 community health centers in Costa Mesa, Newport, Anaheim, Santa Ana and Mission Viejo.

We are looking for a Bilingual Revenue Cycle Specialist to join our Revenue Cycle team! This position is an onsite position in our Newport Beach Office. Our Salary range is $19.00 - $27.00 Depending on Experience/Certifications.

Top reasons to join the SOS team:

• We are mission minded with strong values
• We have been serving the orange county community for over 50 years
• We are a growing organization with growth opportunity
• We offer great work schedule that are Monday - Friday
• We offer competitive salary and benefits

JOB SUMMARY: The Revenue Cycle Specialist is the liaison and subject matter expert (SME) on proper billing practices and will work alongside the Sr Revenue Cycle Manager (RCM) to ensure billing audit tools are in place across the organization and help to streamline billing processes. This position will also be the lead for the No Surprise Act Project as directed the RCM. This position will be a liaison to the clinic team in patient billing errors/denials, supports ongoing process improvement analysis with the RCM; and documentation of billing system P&P and training. This position includes activities within the scope of the billing department/outsourced company including coding, charge/data entry, insurance follow-up, and customer service/support on patient balances. The Revenue Cycle Specialist plays a pivotal role in working with the RCM to maximize revenue collection efficiency. The Revenue Cycle Specialist works in a team based model of care.

JOB RESPONSIBILITIES:

· Contributes to the collaboration of health professionals and members of the health care teams in order to support the patient to attain health goals.

· Responsible for No Surprises Act project by managing Good Faith Estimates work and generating estimates daily & ensuring they are mailed out timely.

· Be a subject matter expert (SME) on discussions on proper billing practices including Medi-Cal, Medicare, managed care, and commercial insurances and work alongside RCM, contracting/credentialing department with any roadblocks

· Works alongside RCM to create and implement a billing audit tool that includes routinely auditing provider documentation and ensuring proper coding capture.

· Performs fee schedule reviews at least yearly with the RCM and works closely with site specialist on maintaining provider master file and fee schedule changes.

· Ability to work alongside clinical and revenue analyst to look at practice management system rules, make logic suggestions and perform testing to streamline billing processes

· Prepare quarterly Medicare Credit Balance Reports and work with consultants for yearly cost reporting for RCM and accounting leadership.

· Participate billing data collection in federal audits as appropriate and necessary

· Acts as liaison to clinic in assisting with patient insurance eligibility questions or concerns

· Works closely with the clinics’ front office, MA, nursing and provider team members to proactively resolve and prevent patient account errors/denials.

· Assists RCM in addressing issues, questions, and problems raised by billing vendor partner, and other team members in the SOS Patient Services Dept regarding patient bills

· Return patient phone calls regarding account balances and/or other matters, providing courteous and compassionate customer service

· Actively work on claim edit and eligibility work queues to resolve errors and reports patterns to RCM

· Document and maintain revenue cycle policies and standard workflows for department and create training materials to support P & P workflow.

· Works with RCM on creating specific workflows and presents trainings around insurance eligibility and registration accuracy via virtual platform or in person.

· Assist RCM in driving internal billing process optimizations

· Reviews billing reports to ensure proper billing procedures are followed based on federal and state rules and regulations and report any trends/issues to RCM.

· Attends meetings and training related to billing procedures as appropriate.

· Interacts closely with Accounting Department to contribute to cash reconciliation activities as needed

· Performs other specific projects related to billing including denial deep dives, data entry, and computer operations as needed.

· Other duties as assigned

· Maintain confidentiality of patient information, organization data and information always in compliance with HIPAA regulations

QUALIFICATIONS:

· Strong working knowledge of Medi-Cal including wraparound, managed care, Medicare and private insurance billing and reimbursement processes including sliding scale discount and self-pay

· Ability to demonstrate a strong analytical and quantitative skills to use data to back up assumptions, recommendations, and drive actions. Knowledge of KPIs that drive billing success.

· Ability to work independently and be resourceful with the ability to multi-task

· Excellent communication skills, both verbal and written

· Bilingual - English/Spanish both written and verbal

· Sensitivity to the needs and situations of a multi-cultural population from a variety of income levels

· Experienced in Microsoft Office applications including Excel, Outlook, Power Point and Word

· Working knowledge/understanding of CPT procedure and ICD-10 coding required.

EDUCATION AND/OR EXPERIENCE:

· Minimum of a high school diploma or GED is required. Associates Degree preferred.

· Minimum of 5 years of in-depth experience in active revenue cycle or relevant professional medical billing

· Previous Community Health or FQHC/RHC experience preferred with Medical, Dental and Behavioral Health focus

· Experience using Electronic Health Records System required; EPIC and Wisdom practice management systems, strongly preferred

· CRCS or CPC Certification desired

COMPENSATION & BENEFITS:

What do we offer? A competitive salary and a generous benefits package for our full time team members which includes; group Medical, Dental and Vision, Flexible Spending Accounts, Basic Life insurance/AD &D, Voluntary Life Options, Long Term Disability, 403b Retirement Plan with employer match, EAP, Global Travel Assistance, Supplemental Accident, Critical Illness and Hospitalization plans offered, CME/Tuition Reimbursement, 10 Paid Holidays, 10 Paid Vacation days and 6 paid Sick days per year.

All qualified candidates will be subject to an employment/criminal background check and must be able to provide proof of required vaccinations which include: COVID-19 Vaccination, TB Test, Annual Flu vaccination and MMR. Required Proof of COVID-19 Vaccine & Booster OR qualify for 1 of the 2 COVID Vaccine Exemptions with weekly rapid testing requirement as per state/federal healthcare requirement. SOS Is a healthcare organization and therefore are mandated to comply with the CDPH Public Health Officer Orders regarding COVID Vaccinations. SOS will provide vaccines to new employee's if needed at no cost.

Job Req # 202209RCSB

Job Type: Full-time

Pay: $19.00 - $27.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• Monday to Friday

COVID-19 considerations:
SOS has a low COVID work policy which requires daily temperature checks, masking, social distancing and hand washing. SOS also provides PPE for all staff members

Education:

• High school or equivalent (Preferred)

Experience:

• Revenue cycle or medical billing: 5 years (Preferred)
• Community Health or FQHC: 1 year (Preferred)
• EHR systems: 1 year (Preferred)

Language:

• Spanish (Preferred)

Work Location: One location

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