Campus Pride Jobs

JOB SUMMARY The Public Health Revenue Cycle Specialist plays a critical role in optimizing the financial processes that support public health services. This position involves managing billing and coding, ensuring regulatory compliance, and maximizing reimbursements from public and private payers. By collaborating with providers, insurers, and government agencies, the specialist ensures the financial health of public health programs while improving access t Essential Duties ESSENTIAL JOB FUNCTIONS

(The following duty statements are illustrative of the essential functions of the job and do not include other non-essential or marginal duties that may be required. Mesa County reserves the right to modify or change the duties or essential functions of this job at any time. All responsibilities may not be performed by all incumbents.)

Billing & Coding: Review, analyze, and process billing claims, including medical codes (CPT, ICD-10) to ensure accuracy and compliance with regulations. System Management: Utilize healthcare billing software and electronic health record (EHR) systems to manage claims, track reimbursements, and maintain accurate documentation. Claims Management: Submit and track insurance claims to public and private payers, monitor denials, and follow up on unpaid claims to ensure optimal reimbursement. Revenue Cycle Optimization: Identify opportunities for process improvement within the revenue cycle, including billing, coding, collections, and payer interactions. Compliance: Stay current on changes in public health policies, insurance regulations, and coding guidelines to ensure adherence to all federal and state healthcare laws (e.g., HIPAA, CMS, Medicaid). Patient Financial Services: Support patient billing inquiries, ensuring that patients receive accurate and timely statements regarding their financial responsibility for services. Reconciliation: Regularly reconcile accounts to ensure payments are received and recorded properly, working with the finance team to address discrepancies. Documentation and Reporting: Maintain accurate records of billing and reimbursement activities, prepare financial reports, and assist in audits as necessary. Collaboration: Work with clinical teams, administrative staff, and external partners (insurers, government agencies) to resolve any issues related to billing, coding, or claims processing. Data Analysis: Analyze revenue cycle data to identify trends, prepare reports, and provide recommendations for improving cash flow and overall revenue cycle efficiency. Training and Support: Provide guidance and training to healthcare providers and staff regarding coding, billing practices, and changes in regulations.

NON ESSENTIAL JOB FUNCTIONS

Participates in emergency planning and response activities. Participates in agency-wide activities that may include strategic planning, quality improvement, and/or staff development, as appropriate. Completes necessary training through FEMA, including Incident Command Structure (ICS) courses. When a local declaration of emergency or disaster is declared by County leadership, employees may be required to work as part of a National Incident Management System (NIMS). Performs other duties as assigned. Minimum Requirements MINIMUM QUALIFICATIONS REQUIRED

Bachelor s degree in Health Administration, Public Health, Business Administration, or a related field. Minimum of 2-3 years of experience in revenue cycle management, billing, coding, or healthcare finance, preferably within healthcare settings Familiarity with public health insurance programs, including Medicaid, Medicare, and other government payer systems Strong knowledge of medical terminology, CPT, ICD-10 coding, and healthcare billing regulations. Certification in Medical Billing and Coding (CPC, CCS) or equivalent preferred. Experience working within public health settings or with public health-related programs preferred. Familiarity with healthcare billing software and electronic health records (EHR) preferred. Experience analyzing revenue cycle data to identify trends and make data-driven recommendations preferred. Knowledge of federal and state healthcare laws and regulations, such as HIPAA and CMS guidelines preferred. Skills & Competencies

Excellent attention to detail and organizational skills. Strong analytical and problem-solving abilities. Ability to work effectively under pressure, prioritize tasks, and meet deadlines. Excellent communication and interpersonal skills for interacting with patients, insurance companies, and internal teams. Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint). Supplemental Information PHYSICAL REQUIREMENTS and WORKING ENVIRONMENT

Full-time position. Work is generally confined to a standard office environment with occasional remote work flexibility. Occasional overtime may be required to meet deadlines. This position requires standing, stooping, sitting, bending, twisting, and lifting up to 10 pounds. May be exposed to communicable diseases and infections.