AR Follow Up Coord

RadNet•Owings Mills, MD

About The Position

Artificial Intelligence; Advanced Technology; The very best in patient care. With decades of expertise, we are Radiology Forward. With dynamic cross-training and advancement opportunities in a team-focused environment, the core of our success is its people with the commitment to a better healthcare experience. When you join us as a AR Credentialing Follow Up Coordinator, you will be joining a dedicated team of professionals who deliver quality, value, and access in the 21st century and align all stakeholders- patients, providers, payors, and regulators to achieve the best clinical outcomes. JOB SUMMARY: This AR Credentialing F/U Coordinator is responsible for recognizing Credentialing related denials associated to the relative RARC and CARC codes. The seasoned representative wil research, analyze, and resolve through appropriate workflow processes assigned by accessing pertinent tools and documents to resolve the issue with the payer and/or identifying gaps within internal processes for resolution. This process includes backtracking to capture and ensure all open claims are resolved based upon contracting and credentialing terms.

Requirements

Knowledge of medical terminology and a working knowledge of different types of insurance plans.
Customer service oriented and possess a courteous and professional telephone manner.
Ability to type and have a general computer aptitude. Must be able to maintain professional judgment.
Ability to verbally communicate thoughts clearly, to read, to write, to file accurately, and to remember information.
Dependable, energetic and ability to multitask.
General computer aptitude.
High School Diploma required.
One to two years’ prior accounts receivable experience in a medical billing environment preferred with at least general knowledge of the healthcare industry insurance/EOB/payment process.
Communicates, cooperates, and consistently functions professionally and harmoniously with all levels of supervision, co-workers, patients, visitors, and vendors.
Demonstrates initiative, personal awareness, professionalism, integrity, and exercises confidentiality in all areas.
Follows all local, state and federal laws concerning employment to include but not limited to: I-9, Harassment, EEOC, Civil rights and ADA.
Follows OSHA regulations, RadNet and site protocols, policies and procedures.
Follows HIPAA, compliance, privacy, safety and confidentiality standards at all times.
Practices universal safety precautions.
Promotes good public relations on the phone and in person.
Adapts and is willing to learn new tasks, methods, and systems.

Responsibilities

Diligently partners and collaborates with Credentialing Depts enterprise-wide and all other support services teams for ultimate outcomes with assigned AR.
Uses, creates, updates Tools as “Source of Truth” files in Payer reconsideration, and appeal efforts.
Runs and analyzes weekly denials for trending (ebbs and flows) for pivoting workflow assignments.
Ensure tools are current and updated at all times and if/when details are updated, notify appreciate bi-coastal leaders for reference and workflow updates.
Maintains assigned territories denial rate under threshold determined by RadNet/RCO standards (data to be determined, and modified as technological opportunities arise). Threshold equates to up to three percent (3%)
Informs management of every procedural road-blocks within forty-eight (48) of find via email communication, as well to be followed up during structured one on one (1:1 meetings)
Maintains accurate and current files/Smartsheet of workflow creating the ability to follow up in designated time, and determine monetary recoveries from daily follow up efforts.
Documents and shares accurate information to all customers, including bi-weekly end of week update/collaboration calls with bi-coastal Credentialing Leaders/Team alike.