Contract Reimbursement Coordinator

Cheyenne Regional Medical Center•Cheyenne, WY

17d

About The Position

This position analyzes and compiles information to ensure accurate financial reimbursement for all payments made to Cheyenne Regional and to ensure payment accuracy per contract. The Coordinator compiles and analyzes over and under payments, as well as payment timeliness, and reports findings in a timely manner to the Director of Billing Services. Why Work at Cheyenne Regional? 403(b) with 4% employer match ANCC Magnet Hospital 21 PTO days per year (increases with tenure) Education Assistance Program Employee Sponsored Wellness Program Employee Assistance Program Loan Forgiveness Eligible Here is What You Will Be Doing: Demonstrates positive interpersonal communication skills when relating to internal and external customers on the telephone and communicates in a courteous, accurate and honest manner. Verifies information on explanation of benefits to reprocess claims in a timely manner to receive accurate reimbursement based on contractual guidelines; uses extensive knowledge of payor contracts and the ability to determine the appropriate reimbursement. Organizes, compiles and analyzes correspondence to determine action needed regarding disposition of denied, unpaid, underpaid and or overpaid claims. Utilizes database to prepare and monitor claim denials; performs analysis of adjustments to accounts and determines accuracy; performs calculations to determine accuracy of payments based on contracts, fee schedules or other payment methodologies. Maintains Library of all Payer Contracts, coordinates with Legal to ensure that all renewal and expiration dates are accurate. Responsible for all ERA/EFT set up with payers, Epic & DSG Maintains Payer Information and review Commercial Generic Report for possible set up of new payers and updates payer information for any changes such as address, phone number, website Negotiates and approves of all Single Case Agreements to include both Physician Billing (PB) and Hospital Billing (HB). Schedules all payer calls, creates agendas and maintains minutes About Cheyenne Regional: Cheyenne Regional Medical Center was founded in 1867 as a tent hospital by the Union Pacific Railroad to treat workers injured while building the transcontinental railroad. Today, we are the largest hospital in the state of Wyoming, employing over 2,000 people, and treating over 350,000+ patients from southeastern Wyoming, western Nebraska, and northern Colorado. We pride ourselves on patient and employee experience by living our core values of Integrity, Caring, Compassion, Respect, Service, Teamwork and Excellence to great health. Our team makes a difference every day by providing trusted healthcare expertise through a passionate and I.N.S.P.I.R.E.(ing) approach with a personal touch. By living our values, we aim to achieve our goal of becoming a 5-star rated hospital, providing critical support and resources to our community and the greater region we serve. If you are eager to make a difference and passionate about healthcare, we encourage you to apply today!

Requirements

Knowledge of federal and state billing and coding regulations, including billing compliance and issues
Knowledge of payor contracts and billing requirements, including government and commercial payors
Critical thinking and analysis skills
Knowledge of the revenue cycle
Ability to effectively analyze payor denials
Ability to identify performance improvement opportunities
Excellent verbal, written, and interpersonal communication skills
Knowledge of computer programs, including billing, document imaging, and Microsoft office products
Bachelor’s Degree or higher • OR, Associate’s degree and two (2) or more years of job-related experience • OR, High School diploma and four (4) or more years of job-related experience

Nice To Haves

Master’s Degree
Four (4) or more years working with Health Insurance Payer Contracts
Medical terminology and coding experience

Responsibilities

Demonstrates positive interpersonal communication skills when relating to internal and external customers on the telephone and communicates in a courteous, accurate and honest manner.
Verifies information on explanation of benefits to reprocess claims in a timely manner to receive accurate reimbursement based on contractual guidelines; uses extensive knowledge of payor contracts and the ability to determine the appropriate reimbursement.
Organizes, compiles and analyzes correspondence to determine action needed regarding disposition of denied, unpaid, underpaid and or overpaid claims.
Utilizes database to prepare and monitor claim denials; performs analysis of adjustments to accounts and determines accuracy; performs calculations to determine accuracy of payments based on contracts, fee schedules or other payment methodologies.
Maintains Library of all Payer Contracts, coordinates with Legal to ensure that all renewal and expiration dates are accurate.
Responsible for all ERA/EFT set up with payers, Epic & DSG
Maintains Payer Information and review Commercial Generic Report for possible set up of new payers and updates payer information for any changes such as address, phone number, website
Negotiates and approves of all Single Case Agreements to include both Physician Billing (PB) and Hospital Billing (HB).
Schedules all payer calls, creates agendas and maintains minutes