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Empowering the Hands that Heal

Clerical Specialist

Columbus, Georgia

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Overview

ScionHealth strives to provide quality-driven, patient-centered acute and post-acute hospital solutions. The health system is focused on driving innovation, serving its communities, and investing in people and technology to deliver compassionate patient care and excellent health outcomes. Based in Louisville, ScionHealth operates 79 hospital campuses in 25 states – 61 long-term acute care hospitals and 18 community hospital campuses and associated health systems.

Success Profile

What do you need to be successful at ScionHealth? Here are the top traits we’re looking for:

  • Communicator
  • Creative
  • Deadline-oriented
  • Goal-oriented
  • Problem-solver
  • Strategic

Our Culture

  • Driven by quality: We believe that if we focus on delivering quality care, exceeding expectations related to customer service and supporting our people, our business results will follow.
  • We equip our hospitals and our people with the resources, technology and expertise they need to deliver the best possible care to patients.
  • We’re always looking to find better ways to support caregivers by improving what we do, sharing best practices, and responding to the changing needs of our people and the patients they serve.
Two doctors standing in hallway

Quote

“ScionHealth allows leaders to inspire the organization to take responsibility for creating a better future.”

Jarrell King Talent Acquisition
Jarrell King, Talent Acquisition

Clerical Specialist

Columbus, Georgia
Facility St. Francis-Emory Healthcare
Req ID 541620 Post Date 05/01/2025 Category Administrative
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Description

At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.

Job Summary

The Revenue Cycle Specialist assists in resolving billing edits that are holding patient claims from Billing, by reviewing medical records and other applicable documentation. This individual will improve the accuracy, integrity and quality of patient charges and will ensure minimal variation in charging practices.  The Revenue Cycle Specialist will coordinate all retrospective, concurrent, patient complaint and external billing audits.

Essential Functions

  • Requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision  
  • Must be able to work in a stressful environment and take appropriate action
  • Working knowledge of precertification and authorizations
  • Exhibits expertise in editing claims for errors and communicating these corrections by eRequest to Parallon
  • Balances, reconciles, and approves the daily deposit for Parallon
  • Effectively explain charges and demonstrates the ability to answer questions concerning patient accounts
  • Interacts in a positive and professional manner with patients/customers and co-workers
  • Ensures the Charge Batch Report is worked and any rejects are corrected in a timely manner
  • Analyzing and resolving patient claims being held by billing edits on the Bill 45, Bill 49, CRT Medical necessity, Correct Coding Initiative, Outpatient code Editor (OCE), Inpatient Code Editor, Self-Administered and other claims requiring clinical expertise’s
  • Interact with ancillary departments to obtain additional information needed to properly bill the account based on medical record documentation
  • Identify charging, coding, or clinical documentation issues and work with ancillary departments to resolve those issues and notify appropriate leadership
  • Serves as a charge master liaison to include regular reviews of CPT codes, Revenue Codes, reviews of monthly standard CDM error report and communicating with Ancillary departments to resolve issues
  • Responsible for maintaining the Physician Master and the Insurance Master file
  • Responsible for any charge error corrections
  • Manages CRNA billing for both the hospital BCBS in State plans and off-site billing company
  • Manages the PLUS report for staff volume
  • Manages and completes all Industrial billing and follow-up
  • Manages and assists ancillary departments with the Charge Audit Tool
  • Responsible for adding Emergency Room Procedure charges
  • Responsible for completion of the Skilled Nursing and Swing bed logs
  • Responsible for exhibits 3, 4, 5, and 8 in the Standard Monthly Accrual (SMA) tool
  • Responsible for balancing the Sleep Lab invoice
  • Responsible for special projects and plays and key role in RAC and audits
  • Displays appropriate office ethics and behavior with regard to interactions with customers, employees, and management. This includes handling conflicts and concerns in a timely and professional manner and utilizing crisis-de-escalation skills when appropriate
  • Displays professionalism while completing multiple urgent tasks in a timely manner
  • Functions as a preceptor or an educational resource in the initial and on-going orientation of new personnel, students, etc.
  • Respects and honors cultural and religious differences between patients and self
  • Responsible for SOX Charge Audits
  • Other duties as requested

Qualifications

Education

  • High School Diploma or equivalent – Required
  • Associate degree – Preferred

Licenses/Certifications

  • Certified Revenue Integrity Professional Certification – Preferred

Experience

  • 1+ year Medical Coding – Required
  • Experience with various payer types - Required
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Benefits

  • Career Development

    We support growth and development for all our employees through various means and in programs designed to foster inclusion.

  • Healthcare

    Your health is important to us. We offer a comprehensive benefits program and resources to support healthy lifestyles for you and your family.

  • Retirement Plan

    Employees can contribute to their retirement with plans that allow for pre-tax or after-tax contributions through payroll deductions.

  • Paid Time Off

    With paid holidays and unlimited PTO, you are encouraged to take the time you need to relax and recharge with family and friends.

  • Work-Life Balance

    Work-life balance is not just a perk, it is encouraged. We believe that our employees work their best when they’re allowed to be their best selves in and out of the office.

  • Miscellaneous Benefits

    Whether you’re looking for pet insurance, identity theft protection, or select discounts from hundreds of local and national merchants, we have a variety of benefits that help provide peace of mind.

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  • Administrative, Columbus, Georgia, United StatesRemove
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