Revenue Operations Specialist

Who We Are:

As the only independent and physician-led faculty practice plan of the University of Tennessee Health Science Center, University Clinical Health (UCH) offers best-in-class clinical care through a network of 175+ providers across 19 specialties to meet the healthcare needs of the Mid-South community. UCH is a not-for-profit, non-tax-supported group practice and is here to serve the community while providing medical excellence to our patients.

Position Summary: The Revenue Operations Specialist (ROS) is responsible for updating patient demographics and verifying insurance benefits. The ROS's additional responsibilities will include utilizing multiple hospital systems and various payer websites, entering alphabetic and numeric medical data from source documents into the practice billing system, checking for entry accuracy, and implementing the Epic claim correction process. The position requires overtime, both during the week and weekends, on an as-needed basis. Limited time off is approved for the last week of the month.

Key Results Areas (KRAs):

• Responsible for Patient registration, including chart creation and demographic data input
• Navigate multiple hospital systems and collect necessary patient demographic and insurance information
• Verification of insurance eligibility through RTS, payer website, or phone calls to the payer
• High-level understanding of medical coding about CPT, ICD 10, modifiers, and POS codes
• Input Charge data including CPT, ICD 10, and modifier codes quickly and accurately on each transaction level/line
• Input insurance data correctly on each billable encounter in Epic
• Manage assigned work queues in Epic to correct errors and produce clean claims
• Ensure up-to-date knowledge of policies and procedures about the Revenue Services department
• Makes appropriate adjustments to patient accounts in accordance with UCH policies
• Assists Patient Account Biller/Collector/Payment Poster as required or assigned
• High level understanding of clinical operations for specialties supported by role
• Maintain a working knowledge of Regulatory Compliance, especially HIPAA and CMS billing guidelines
• Handle patient account calls knowledgably and professionally - investigating account questions and concerns
• Demonstrate teamwork through coordination and ownership of shared responsibilities
• Perform any other duties as assigned

Core Competencies:

• Demonstrated analytical skills
• Prompt response to email and telephone calls
• Exceptional interpersonal and communication skills
• Exceptional customer service skills
• Pays close attention to detail, accuracy, and completeness
• Excellent organizational skills
• Excellent time management skills
• Committed to supporting UCH's standard of medical excellence

Education & Experience:

• High School diploma or equivalent Required
• 5 years of medical office or medical billing experience is strongly Preferred
• Computer knowledge: Word, Excel, Outlook, and electronic medical record experience Required
• Knowledge of medical terminology and insurance claim filing Preferred
• Knowledge of insurance verification systems Preferred
• Knowledge and/or experience with local hospital systems (Cerner, Epic, etc.) Preferred