Revenue Cycle Specialist II

Job Description

Catalpa Health is a pediatric mental health clinic serving over 8,000 children in the Fox Valley annually. Our team members work diligently to meet the needs of our clients, offering families the support they need at the right time, close to home. Our vision to inspire hope and provide world-class mental health care is our driving force and is realized each day through the actions of our team members.

Building a supportive work environment is at the heart of our values. One way of expressing that support is by providing a comprehensive whole-person benefits plan. We believe in providing resources to our team members to support them in all stages of their life’s journey.

Benefits include:

Competitive pay

Referral bonus program

Multiple health insurance plans designed to meet the needs of your family

Dental and vision insurance plans

Short & Long-term disability

401-K Plan with Company Match

Life Insurance, Critical Illness and Accident insurance

Pre-tax FSA and HSA plans, Dependent Care Saving Plan

Generous Paid Time Off plus 9 paid holidays each year (Full time employees earn up to 3 weeks in your first year of employment)

Up to $1500 for Professional development and continuing education annually

Wellness program through Optum that includes additional resources to support your mental health needs, financial and retirement planning, eldercare support services, and more

Work environment:

Casual dress code

Centrally located and close to Fox River Mall

Fun, supportive and dedicated staff members

Position Description:

The Revenue Cycle Specialist II is responsible for preparing, submitting and maintaining enrollment, credentialing and re-credentialing documentation for Catalpa Health’s providers to ensure licensing and certification requirements are met. Credentialing activities will be approximately 50% of this full-time position. The remaining 50% of this position will focus on completing tasks associated with completion of the revenue cycle process.

Essential Functions and Responsibilities:

Manage and complete all aspects of credentialing processes Including but not limited to the following:

Manage new and renewal credentialing applications per payor guidelines

Create and maintain an internal credentialing file for each provider

Manage and maintain records related to malpractice COI’s for providers.

Update payer rosters quarterly

Complete review of Office of the Inspector General (OGI) reports

Complete prior authorization process for services

Completes daily work processes of revenue department related to claim submission and edits, insurance verification, payment plans, account adjustments, billing and collections, and financial assistance

Education, Experience and Certification(s):

High school diploma or equivalent

Minimum of 2+ years of experience in health care credentialing, billing and insurance tasks

Previous experience with electronic medical record software, specifically Epic - Resolute

Certified Revenue Cycle Representative, Billing Specialist or Health Information Technician (Preferred)

Skills and Abilities:

Strong attention to detail and accuracy in data entry

Excellent written and verbal communication skills

Understanding of HIPAA

Experience with CMS and State of WI Medicaid Billing

Able to prioritize work and meet deadlines

Proficient with MS Office applications

Catalpa Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Full-time