Revenue Cycle System Administrator
Summary
Maintains and supports the EHR/practice management system for the revenue cycle — scheduling, patient financials, billing, and provider credentialing/payer enrollment — while keeping licenses and credentials current. Collaborates with HIT, clinical informatics, and revenue cycle leaders on upgrades, data integrity, analytics, and training.
POSITION SUMMARY
Maintains and updates the electronic health record (EHR) system as it pertains to practice management and the revenue cycle, including scheduling, patient financials, guarantor information, billing, provider credentialing, recredentialing, and payer enrollment. Coordinates administrative credentialing activities by verifying professional licenses and credentials; maintaining licensing, credentialing, and insurance records; monitoring expiration and renewal dates; and notifying staff of required renewal deadlines. Supports the development of internal credentialing processes. Ensures organizational and medical staff compliance with regulatory and accrediting requirements by maintaining credentialing databases and confirming that licenses, credentials, and insurance documentation remain valid and current, preventing lapses. Collaborates closely with HIT, clinical informatics and the revenue cycle leaders.
The requirements listed below are representative of the knowledge, skills and /or abilities required and may include other duties as assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
It is expected that the employee demonstrate behavior consistent with the Core Values and support the strategic plan and the goals and direction of the Performance Improvement Plan.
EDUCATION/TRAINING EXPERIENCE
- Bachelor’s Degree or equivalent experience
- Four to five years of healthcare billing experience
- Experience with provider credentialing, recredentialing, payer enrollment, and maintenance of credentialing records preferred
- Health Information Technology preferred
LICENSES/CERTIFICATIONS
- NONE
THE ESSENTIAL DUTIES OF THE POSITION
- Provides ongoing maintenance and support of the revenue cycle/practice management system, including database configurations, appropriate profile setting and baseline testing
- Ensures the accuracy and integrity of the revenue cycle data
- Evaluate optimizations of revenue cycle processes from intake, scheduling, claims and posting, making recommendations to minimize errors and maximize revenue
- Leverage innovative technology and strategies to enhance revenue cycle functions
- Serves as a liaison between practice management areas and HIT to support the development and implementation of platform upgrades, seamlessly integrating with the clinical workflow
- Provides analytics and support to program teams as requested in the areas of data reconciliation, data analysis, reports, and responses to financial inquiries
- Develop training curriculum and conduct format training sessions as needed