Revenue Cycle Coordinator

Summary:
 

Perform fiscal clerical work and review involved with billing to fiscal intermediaries for medical and dental services rendered. Revenue Cycle Coordinators are involved in working with medical billing records, reviewing, and verifying insurance and claim payments to accounts against third party billing program provisions and procedures. Revenue Cycle Coordinators are expected to solve routine problems without assistance while unusual problems are referred to a supervisor.

Compensation:

$20.17 - $23.53 per hour 

Essential Duties and Responsibilities:
 

-Supports the revenue cycle process as an additional liaison between revenue cycle team and outsourced billing team.

-Research billing and collections information to third party intermediaries for services rendered or for fees or other related charges.

-Perform reviews to determine and prioritize claims submission, rejection, and denials issues as seen through claims transactions/results from Payers.

-Review patient accounts to verify the accuracy of information and communicate required changes for proper billing purposes.

-Review patient insurance as needed for completeness and accuracy required by county programs, government payers and private insurance carriers for filing and payment on medical and dental claims.

-Follow-up on payment with insurance payers and patients on outstanding accounts as needed.

-Respond to requests for account information concerning status of account, patient liability and general billing procedures to the revenue cycle team or outsourced billing team.

-Check and communicate account or numerical records for arithmetical billing errors to outsourced billing team.

-Monitor and submit explanation of benefits and payment information needed for payment posting to outsourced billing team.

-Provide input to policies, systems, methods and procedures for the effective management and control of the premium billing function

-Performs accurate and timely review of patient accounts in accordance with policies and procedures and in compliance with federal, state, insurance carriers, health plans and other third party payor requirements, as assigned.

QUALIFICATIONS:

Experience:

One year of experience performing financial, statistical, or fiscal record keeping work, including medical billing.

Or

Two years of clerical experience, one of which involved making arithmetical

computations of performing some financial, statistical, or fiscal record keeping and billing

work, preferably medical billing; One year of the non-specialized experience may be

substituted by either: Completion of 18 semester or 27 quarter units from a recognized college in business education or a closely related field.

Minimum Qualifications:

1. Diploma from an approved High School or GED Equivalent.

2. Billing Certificate and/or minimum of two years’ experience in a medical billing position, preferably in a non-profit organization

3. Managed care and collections management experience preferred. Knowledge of OSHA, Title XXII, HIPAA, Corporate Compliance, and Rural Health Regulations preferred

Knowledge, Skills and Abilities:

1. Excellent oral and written communication skills

2. Effective interpersonal skills

3. Detail oriented with the ability to work with minimal to no supervision

4. Ability to interface with all levels of personnel in a professional manner

5. Ability to work with people of all social and ethnic backgrounds

6. Work independently and as a team, take initiative

7. Ability to handle multiple projects, prioritizes, and meets deadlines

8. Able to use computer, calculator, telephone, operate fax, and copy machine

Physical and Mental Requirements:

1. Able to lift/move up to 40 pounds, move from place to place, and stand for long periods of time

2. Ability to do math, organize and prioritize workload, work effectively and efficiently under stress

3. Ability to supervise, multitask, understand and follow instructions

4. Ability to proficiently read, write, speak and understand English

CUSTOMER SERVICE:

1. Actively supports, promotes, and works to fulfill the Mission, Vision and core values of Borrego Health

2. Provides excellent internal and external customer service

3. Demonstrates Borrego Health’s Standards of Customer Service Behavior: Compassion, Attitude, Communication, Appearance, Sense of Ownership, and Teamwork

4. Participates in on-going customer service trainings

5. In every action, seeks to promote Borrego Health as a top service organization

QUALITY MANAGEMENT:

1. Contributes to the success of the organization by participating in quality improvement activities

2. Complies with all Borrego Health policies and procedures and pro-actively participates in the implementation of new initiatives

SAFETY:

1. Ensures compliance with policies and procedures related to safe work practices

2. Uses all appropriate equipment and/or tools to ensure workplace safety

3. Immediately reports unsafe working conditions

PRIVACY/COMPLIANCE:

1. Maintains privacy and security of all patient, employee, and volunteer information and access to such information. Such information is accessed on a need to know basis for business purposes only

2. Complies with all regulations regarding corporate integrity and security obligations. Reports unethical, fraudulent or unlawful behavior or activity

3. Upholds strict ethical standards

Flexibility:

1. Available for all shifts and, when required, able to work evenings and weekends