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La Clinica del Pueblo

Revenue Cycle Coordinator

La Clinica del Pueblo, Hyattsville, Maryland, United States, 20780

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Job Title Revenue Cycle Coordinator

Department Finance

Supervisor Patient Revenue Manager

Location Hyattsville, MD

Classification Salary / Exempt

Base Pay Range $60,000.00/yr - $70,000.00/yr

Synopsis Under the supervision of the Patient Revenue Manager, the Revenue Cycle Coordinator prepares and submits timely and accurate insurance claims to third‑party payers using eClinicalWorks (eCW), verifies and posts payments and adjustments, manages aging reports, and follows up on denied or underpaid claims. The Coordinator also assists with payer enrollments for all providers, ensures credentialing documentation is complete and submitted in a timely manner, and maintains compliance with FQHC and payer‑specific requirements.

Required Qualifications

High school diploma or equivalent

Understanding of payer EOBs/Remits

Strong computer skills including Microsoft Word and Excel

Minimum of 2–3 years of experience using ICD‑10, HCPCS, CPT, medical coding and billing

Minimum of 2–3 years of experience in a revenue cycle billing position (experience with medical billing, patient registration, or insurance verification)

Experience using electronic medical records (EMR); eCW preferred

Excellent oral, written, and telephone communication

Working knowledge of rules and regulations pertaining to the FQHC guidelines

Ability to prioritize and manage multiple tasks with efficiency in dealing with multiple facilities, departments and programs

Ability to handle a large volume of project receiving, submitting and researching claims

Ability to work independently with minimum supervision in a team‑oriented environment and interrelates well with individuals with diverse ethnic and cultural backgrounds and needs

Preferred Qualifications

eCW experience preferred

Registration/intake experience preferred

Payer enrollment experience preferred

Knowledge of medical terminology and practices

Duties and Responsibilities

Prepares and submits clean claims to various insurance companies either electronically or paper

Reviews and posts denials to accounts according to the EOB to ensure accurate payment status and account activity

Reviews and assigns claims that need provider attention via jellybeans in eCW to appropriate staff

Prepares bank reconciliation log daily to report incoming insurance checks/deposits

Monitors aging reports and takes necessary actions to guarantee payments of claims

Reviews accounts daily and makes phone calls or checks insurance portals to assigned insurance groups for insurance follow‑up to determine claim adjudication

Assures compliance with applicable billing laws and regulations to maximize cash receipts

Contacts insurance carriers regarding non‑payments and/or improper payment on claims

Identifies problem accounts with payers; investigates and corrects errors

Follows‑up on missing account information and resolves past‑due accounts

Prepares reports to identify and resolve accounts receivable

Helps with year‑end reports such as patient revenue reports, adjustments, aging report, charity care, etc

Posts patient payments to accounts and applies payment to claims

Posts ERA payments, adjustments, and write‑offs to appropriate accounts

Prepares, reviews, and sends patient statements

Reviews telephone encounters assigned for patient account follow‑up

Answers inquiries by phone regarding past‑due accounts and insurance guidelines

Transfers bills to secondary or tertiary accounts, if applicable

Makes adjustments to either patient or practice accounts based on internal reports and/or documentation

Responsible for reading and understanding various types of Explanation of Benefits

Keeps supervisor informed of areas of concern and problems identified

Assists in the preparation of monthly reports to ensure accuracy and timely processing of claims billed through the EMR

Prepares and distributes monthly Unlocked Encounters Report to ensure all visits are locked and ready to bill for the month

Assists with preparing and submitting provider enrollment and revalidation applications to commercial and government payers (e.g., Medicare, Medicaid, MCOs)

Assists with enrollment application status and follow‑up with payers to ensure timely processing

Assists with maintaining accurate and current enrollment records, rosters, and CAQH profiles

Assists with updating and maintaining provider and organizational information in payer portals and directories

Maintains strict confidentiality regarding confidential conversations, documents, and files

Participates in educational activities and attends monthly staff meetings

Adheres to all HIPAA guidelines/regulations

Perform other related duties as assigned

Physical Requirements

Prolonged periods of sitting at a desk and working on a computer

Must be able to lift up to 15 pounds at times

Supervisory Responsibilities None

Seniority Level Entry level

Employment Type Full‑time

Job Function Accounting/Auditing and Finance

Industries Hospitals and Health Care

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