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AllCare Primary and Immediate Care has grown into a trusted provider of comprehensive healthcare services with over 30 locations across Maryland, Virginia, and Washington DC. We are committed to continuous expansion and are proud to bring convenient access to high-quality primary care to communities in need. Senior Revenue Cycle Coordinator works under the direction of the Billing Manager, responsible for assisting with the billing operations for AllCare. The essential functions include accurate and timely code selection and charge submission for all professional billable services. The Senior Revenue Cycle Coordinator helps manage insurance claims and payments. The day-to-day work of the Senior Revenue Cycle Coordinator includes Properly coding services, procedures, diagnoses, and treatments as needed. Preparing and sending claims for payment. Providing credentialing oversite for the Allcare credentialing team. This description is intended to describe the essential job duties and the essential requirements for the performance of this job, it is not intended to cover all possible aspects of the job Requirements
Has a contagious and positive work ethic, inspires others, and models the AllCare values. Demonstrates effective verbal and written communication that is clear, well-organized, and demonstrates an understanding of audience needs. Adherence to standards of business conduct and compliance. Credentialing
Oversee the on-boarding of new providers Keep and maintain files within one-drive and Medallion for provider demographics and licensing Provide credentialing status’ of all providers to Billing manager Provide continuous communication to front desk and call center operations regarding provider and location updates. Work with training team on insurances by providing continuous updates and reports Front End
Verify coverage and eligibility for medical services. Communicate with insurance providers and patients. Review patient bills and correct any missing or inaccurate information. Assist with timely resolution to billing/claim edits or “holds” in the PM system. Use billing software to prepare and transmit claims. Responsible for validating coding and billing information required to clear edits. Remain current with regulations and coding guidelines regarding new and existing procedures for appropriate code assignment. Follow the coding and compliance program as created by the Coding and Compliance manager including, controls and compliance measurements consistent with operation policies and documentation. Work directly with providers in correcting coding and documentation as needed. Accurately capture appropriate coding by reviewing encounter documentation. Validate billing information required to clear edits. Collect unpaid claims and clear up discrepancies. Identifying and billing secondary or tertiary insurances. Work with patients to set up payment plans. Assists with following up on unpaid claims within standard billing cycle timeframe. Assists with payment/remit issues to ensure timely posting of all transactions. Assists with patient calls or questions related to billing and self-pay balances. Work on special projects, committees, and task forces as assigned. Maintain patient, physician, and financial confidentiality. Participate in professional development activities and maintain professional affiliations. Other duties as assigned. Experience with Athena EMR and PM systems (Preferred)
5+ years with Athena Comprehensive understanding and working knowledge of CMS documentation, coding, and compliance regulations and requirements. Working knowledge of the coding systems. Provider documentation, coding, and charge capture knowledge. Knowledge of accepted principles, practices relating to general healthcare professional provider operations. Must be computer literate to complete task(s) as required. Experience with credentialing
2-4 years experience Firm understanding of provider credentialing Understanding of Medicare guidelines and process Working knowledge of websites for credentialing Coding
10+ years experience with ICD-10 and CPT coding Understanding of claims creation Working knowledge of medical terminology and abbreviations and healthcare nomenclatures Strong Knowledge of coding and the billing processes. Must be able to work with providers to provide guidance on billing. Working Conditions
Work Location : Remote - You must be able to provide a secure/HIPAA compliant environment where you will be working. Non-Center Based. Requires: the ability to sit at a computer for hours at a time (with some bending and stooping) and travel to Centers (if so, the noise level is moderate and there is potential for exposure to infectious diseases and blood-borne pathogens).
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AllCare Primary and Immediate Care has grown into a trusted provider of comprehensive healthcare services with over 30 locations across Maryland, Virginia, and Washington DC. We are committed to continuous expansion and are proud to bring convenient access to high-quality primary care to communities in need. Senior Revenue Cycle Coordinator works under the direction of the Billing Manager, responsible for assisting with the billing operations for AllCare. The essential functions include accurate and timely code selection and charge submission for all professional billable services. The Senior Revenue Cycle Coordinator helps manage insurance claims and payments. The day-to-day work of the Senior Revenue Cycle Coordinator includes Properly coding services, procedures, diagnoses, and treatments as needed. Preparing and sending claims for payment. Providing credentialing oversite for the Allcare credentialing team. This description is intended to describe the essential job duties and the essential requirements for the performance of this job, it is not intended to cover all possible aspects of the job Requirements
Has a contagious and positive work ethic, inspires others, and models the AllCare values. Demonstrates effective verbal and written communication that is clear, well-organized, and demonstrates an understanding of audience needs. Adherence to standards of business conduct and compliance. Credentialing
Oversee the on-boarding of new providers Keep and maintain files within one-drive and Medallion for provider demographics and licensing Provide credentialing status’ of all providers to Billing manager Provide continuous communication to front desk and call center operations regarding provider and location updates. Work with training team on insurances by providing continuous updates and reports Front End
Verify coverage and eligibility for medical services. Communicate with insurance providers and patients. Review patient bills and correct any missing or inaccurate information. Assist with timely resolution to billing/claim edits or “holds” in the PM system. Use billing software to prepare and transmit claims. Responsible for validating coding and billing information required to clear edits. Remain current with regulations and coding guidelines regarding new and existing procedures for appropriate code assignment. Follow the coding and compliance program as created by the Coding and Compliance manager including, controls and compliance measurements consistent with operation policies and documentation. Work directly with providers in correcting coding and documentation as needed. Accurately capture appropriate coding by reviewing encounter documentation. Validate billing information required to clear edits. Collect unpaid claims and clear up discrepancies. Identifying and billing secondary or tertiary insurances. Work with patients to set up payment plans. Assists with following up on unpaid claims within standard billing cycle timeframe. Assists with payment/remit issues to ensure timely posting of all transactions. Assists with patient calls or questions related to billing and self-pay balances. Work on special projects, committees, and task forces as assigned. Maintain patient, physician, and financial confidentiality. Participate in professional development activities and maintain professional affiliations. Other duties as assigned. Experience with Athena EMR and PM systems (Preferred)
5+ years with Athena Comprehensive understanding and working knowledge of CMS documentation, coding, and compliance regulations and requirements. Working knowledge of the coding systems. Provider documentation, coding, and charge capture knowledge. Knowledge of accepted principles, practices relating to general healthcare professional provider operations. Must be computer literate to complete task(s) as required. Experience with credentialing
2-4 years experience Firm understanding of provider credentialing Understanding of Medicare guidelines and process Working knowledge of websites for credentialing Coding
10+ years experience with ICD-10 and CPT coding Understanding of claims creation Working knowledge of medical terminology and abbreviations and healthcare nomenclatures Strong Knowledge of coding and the billing processes. Must be able to work with providers to provide guidance on billing. Working Conditions
Work Location : Remote - You must be able to provide a secure/HIPAA compliant environment where you will be working. Non-Center Based. Requires: the ability to sit at a computer for hours at a time (with some bending and stooping) and travel to Centers (if so, the noise level is moderate and there is potential for exposure to infectious diseases and blood-borne pathogens).
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