North Mississippi Health Services
Revenue Cycle Coordinator
North Mississippi Health Services, Winfield, Alabama, United States, 35594
Job Summary
Title: Revenue Cycle Coordinator at North Mississippi Health Services. Responsibility: Support timely and effective Revenue Cycle flow to facilitate payment capture through bill processing and denial and contract management. Technical knowledge, organizational and communication skills to manage follow up and coordination with payers, vendors, and staff members to resolve claim issues, facilitate contractual compliance, generate reporting, analyze opportunities for improvement, and implement solutions to realize more effective flow and support of payment capture.
Job Functions Billing & Follow Up
Processes Billing by receiving, interpreting, processing, and submitting through various edits to third party payors billing electronically and hard copy format.
Completes Billing follow up by contacting third party payers or accessing payer websites/provider portals to determine payment expectation and resolve any problem on the claim.
Facilitates information communications and processing by interpreting and processing third party payor and patient inquiries in an accurate and timely manner to expedite payment.
Denial Management
Manages denial receivable to resolve accounts.
Develops strategy for appeal, appeal follow-up and/or reprocessing accounts.
Analyzes denials to determine reason they occurred.
Identifies trends and reports significant and recurring issues along with possible solutions to Denials Management Supervisor and Billing Manager.
Takes corrective action through systematic and procedural development to reduce or eliminate payment issues.
Contract Management
Possesses familiarity with payer methodologies and the ability to communicate with NMHS staff.
Manages paid claims to resolve underpaid accounts.
Develops strategy for appeal, appeal follow-up and/or reprocessing accounts.
Analyzes underpayments to determine reason they occurred.
Identifies trends and reports significant and recurring issues along with possible solutions to the Denials and Underpayment manager.
Communication
Professionally and effectively communicates with third party carriers, vendors, and hospital contacts to promote contractual compliance.
Liaison
Contacts insurance companies regarding denial, underpayments or rejection issues.
Serves as liaison between payers and hospital departments/physician offices or patients in resolving denials and/or underpayment issues.
Reporting
Assists in preparation of monthly denial reports and other denial reports as requested.
Assists in preparation of monthly variance reports and other variance reports as requested.
Regulation Adheres to NMHS/NMMC Policies/Procedures/Guidelines. Complies with applicable Local/State/Federal policies/procedures/guideline/regulations/laws/statues.
Qualifications Education
High School Diploma or GED Equivalent or equivalent. Required
Licenses and Certifications
None specified
Work Experience
1-3 years
Knowledge, Skills and Abilities
Ability to research, analyze and communicate payer trends to identify reimbursement and training issues; required
Excellent analytical and problem-solving skills
Good organizational and communication (written and verbal) skills
Excellent interpersonal skills
Computer skills with strong Microsoft Office, Outlook, Third Party Payer websites; preferred
Must professionally and effectively communicate with third party carriers, vendors, and hospital contacts to promote contractual compliance and recommend corrective and preventative actions
Must provide input and help design payer report cards in conjunction with contracting, managed care, and other revenue cycle departments
Must participate as member of the Denials Committee
Must conduct training sessions with Billing and Follow-up staff as needed
Must have effective negotiating skills including the ability to resolve difficult claims issues
Must be able to gather and share information with knowledge, tact, and diplomacy
Must have extensive contact with: patients, payers, physician office staff, coding staff, Credentialing, Case Management, various Department heads, and all staff within the department
Physical Demands
Standing: Constantly
Walking: Frequently
Sitting: Rarely
Lifting/Carrying: Frequently 50 lbs
Pushing/Pulling: Frequently
Climbing: Occasionally
Balancing: Occasionally
Stooping/Kneeling/Bending: Frequently
Reaching/Over Head Work: Frequently
Grasping: Frequently
Speaking: Occasionally
Hearing: Constantly
Repetitive Motions: Constantly
Eye/Hand/Foot Coordinations: Frequently
Benefits
Continuing Education
403B Retirement Plan with Employer Match Contributions
Pet, Identity Theft and Legal Services Insurance
Wellness Programs and Incentives
Referral Bonuses
Employee Assistance Program
Medical Benefits
Dental Benefits
Vision Benefits
License+ Certification Reimbursement
Life, Long-Term and Short-Term Disability, Group Accident, Critical Illness and Hospital Indemnity Insurance
Employee Discount Program
Other: Early Access to Earned Wages
Tuition Assistance
Relocation Assistance
Paid Time Away
Special Employee Rates at NMMC Wellness Centers
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Job Functions Billing & Follow Up
Processes Billing by receiving, interpreting, processing, and submitting through various edits to third party payors billing electronically and hard copy format.
Completes Billing follow up by contacting third party payers or accessing payer websites/provider portals to determine payment expectation and resolve any problem on the claim.
Facilitates information communications and processing by interpreting and processing third party payor and patient inquiries in an accurate and timely manner to expedite payment.
Denial Management
Manages denial receivable to resolve accounts.
Develops strategy for appeal, appeal follow-up and/or reprocessing accounts.
Analyzes denials to determine reason they occurred.
Identifies trends and reports significant and recurring issues along with possible solutions to Denials Management Supervisor and Billing Manager.
Takes corrective action through systematic and procedural development to reduce or eliminate payment issues.
Contract Management
Possesses familiarity with payer methodologies and the ability to communicate with NMHS staff.
Manages paid claims to resolve underpaid accounts.
Develops strategy for appeal, appeal follow-up and/or reprocessing accounts.
Analyzes underpayments to determine reason they occurred.
Identifies trends and reports significant and recurring issues along with possible solutions to the Denials and Underpayment manager.
Communication
Professionally and effectively communicates with third party carriers, vendors, and hospital contacts to promote contractual compliance.
Liaison
Contacts insurance companies regarding denial, underpayments or rejection issues.
Serves as liaison between payers and hospital departments/physician offices or patients in resolving denials and/or underpayment issues.
Reporting
Assists in preparation of monthly denial reports and other denial reports as requested.
Assists in preparation of monthly variance reports and other variance reports as requested.
Regulation Adheres to NMHS/NMMC Policies/Procedures/Guidelines. Complies with applicable Local/State/Federal policies/procedures/guideline/regulations/laws/statues.
Qualifications Education
High School Diploma or GED Equivalent or equivalent. Required
Licenses and Certifications
None specified
Work Experience
1-3 years
Knowledge, Skills and Abilities
Ability to research, analyze and communicate payer trends to identify reimbursement and training issues; required
Excellent analytical and problem-solving skills
Good organizational and communication (written and verbal) skills
Excellent interpersonal skills
Computer skills with strong Microsoft Office, Outlook, Third Party Payer websites; preferred
Must professionally and effectively communicate with third party carriers, vendors, and hospital contacts to promote contractual compliance and recommend corrective and preventative actions
Must provide input and help design payer report cards in conjunction with contracting, managed care, and other revenue cycle departments
Must participate as member of the Denials Committee
Must conduct training sessions with Billing and Follow-up staff as needed
Must have effective negotiating skills including the ability to resolve difficult claims issues
Must be able to gather and share information with knowledge, tact, and diplomacy
Must have extensive contact with: patients, payers, physician office staff, coding staff, Credentialing, Case Management, various Department heads, and all staff within the department
Physical Demands
Standing: Constantly
Walking: Frequently
Sitting: Rarely
Lifting/Carrying: Frequently 50 lbs
Pushing/Pulling: Frequently
Climbing: Occasionally
Balancing: Occasionally
Stooping/Kneeling/Bending: Frequently
Reaching/Over Head Work: Frequently
Grasping: Frequently
Speaking: Occasionally
Hearing: Constantly
Repetitive Motions: Constantly
Eye/Hand/Foot Coordinations: Frequently
Benefits
Continuing Education
403B Retirement Plan with Employer Match Contributions
Pet, Identity Theft and Legal Services Insurance
Wellness Programs and Incentives
Referral Bonuses
Employee Assistance Program
Medical Benefits
Dental Benefits
Vision Benefits
License+ Certification Reimbursement
Life, Long-Term and Short-Term Disability, Group Accident, Critical Illness and Hospital Indemnity Insurance
Employee Discount Program
Other: Early Access to Earned Wages
Tuition Assistance
Relocation Assistance
Paid Time Away
Special Employee Rates at NMMC Wellness Centers
#J-18808-Ljbffr