Medicine Revenue Cycle Management Coordinator

University of Maryland Faculty Physicians•Baltimore, MD

12h

About The Position

The Revenue Cycle Management Coordinator is a multi-disciplinary role, which combines work from key revenue cycle functions within the Department of Medicine’s Billing Office (DOMBO), to include but not limited to: accounts receivable, charge entry, and payment posting. The RCMC 1 will have primary, secondary and tertiary responsibilities, thus will report to the Manager or Supervisor who has oversight of the primary responsibilities. The respective Manager or Supervisor will collaborate with the Manager or Supervisor who has oversight of the secondary and tertiary responsibilities to determine work allocation to ensure that the RCMC is focusing on the greatest need that supports initiatives within the Department of Medicine and DOMBO. The RCMC 1 is responsible for 1) entering patient demographics, insurance information, and professional charges, 2) working accounts receivable and denials for assigned payers, and 3) posting and reconciling payments into the professional billing system for services rendered by Department of Medicine (DOM) Physicians and Advanced Practice Providers (APP). The RCMC 1 ensures that all information entered in the professional fee billing system is precise and accurate; and other duties as assigned. ESSENTIAL FUNCTIONS Works across at least 3 revenue cycle management disciplines and prioritizes areas of greatest need/focus. Ability to navigate complex disciplines with multiple locations, billing areas, and/or special workflows. Researches and conducts insurance verifications for applicable accounts with outstanding balances and/or on denied claims. Performs daily follow up on rejected claims in 5 or more insurance classes. Ability to work across all insurance classes, prioritizing work based on the greatest need/focus. Ability to create summaries of claims/denials issues within each insurance class. Performs daily follow up on a variety of reports that identify patient accounts with outstanding balances. Reviews applicable authorizations/referrals to ensure that they are valid for the service being entered.

Requirements

High school diploma or general education degree (GED) preferred
Three or more years of experience in a physician billing office
Experience with resolution of claims edits preferred
PC proficiency, to include but not limited to, MS Office software
Knowledge of Athena/GE/IDX, EPIC, or similar computerized billing system
Knowledge of payers in specialty
Knowledge of ICD-10 and CPT coding
Understanding of FSC's used in Athena/GE/IDX system
Understanding of contractual requirements for the job
Understanding of importance of compliance with all government regulations regarding billing

Responsibilities

Entering patient demographics, insurance information, and professional charges
Working accounts receivable and denials for assigned payers
Posting and reconciling payments into the professional billing system for services rendered by Department of Medicine (DOM) Physicians and Advanced Practice Providers (APP)
Ensuring that all information entered in the professional fee billing system is precise and accurate
Works across at least 3 revenue cycle management disciplines and prioritizes areas of greatest need/focus
Researches and conducts insurance verifications for applicable accounts with outstanding balances and/or on denied claims
Performs daily follow up on rejected claims in 5 or more insurance classes
Ability to work across all insurance classes, prioritizing work based on the greatest need/focus
Ability to create summaries of claims/denials issues within each insurance class
Performs daily follow up on a variety of reports that identify patient accounts with outstanding balances
Reviews applicable authorizations/referrals to ensure that they are valid for the service being entered