Cheyenne Regional Medical Center-posted 18 days ago
Full-time • Mid Level
Cheyenne, WY

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? ANCC Magnet Hospital 403(b) with 4% employer match 21 PTO days per year (increases with tenure) Education Assistance Program Employer Sponsored Wellness Program Employee Assistance Program Loan Forgiveness Eligible

  • 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
  • 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
  • Master’s Degree
  • Four (4) or more years working with Health Insurance Payer Contracts
  • Medical terminology and coding experience
  • ANCC Magnet Hospital
  • 403(b) with 4% employer match
  • 21 PTO days per year (increases with tenure)
  • Education Assistance Program
  • Employer Sponsored Wellness Program
  • Employee Assistance Program
  • Loan Forgiveness Eligible
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