Revenue Assurance Coordinator

RadNet

1d•Onsite

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 Revenue Assurance 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. The Revenue Assurance Coordinator (RAC) will be responsible for receiving and analyzing Revenue Variance Reports for West Coast Radnet centers, performing an analysis of the data to isolate variances for further research, and investigating the reason for the variance, including identification of front end, back end, and NPD discrepancies. This role also involves performing necessary research on variances within various systems to determine the viability of revenue recovery, notifying appropriate parties for the appellate process, maintaining open dialogue with Reimbursement Operations personnel and contracting, and coordinating with leadership to ensure payor-initiated modifications are implemented and issues resolved. Additionally, the coordinator will prepare and maintain Revenue Assurance Module Variance Tables, prepare monthly Dashboard Reports, assist in implementing procedures and best practices, and perform other assigned duties.

Requirements

High school diploma required
Must have at least 3 years of internal or external experience in the health care insurance and/or insurance reimbursement field
Excellent computer skills, especially a strong knowledge of Microsoft Excel and Word
Knowledge and understanding of payors, contracting, insurance types/classes, CPT codes and fee schedules
Understands the proprietary nature of fee schedules and associated contracts and will not release any of this proprietary information without prior written consent.
Superior analytical, written and oral communication skills; Fluency (written and oral) in English required
Ability to work well in group and individual settings
Ability to foresee potential problems and offer solutions
Ability to handle moderately complex assignments under minimal supervision is essential
Ability to work Monday-Friday 8:00 am - 4:30 pm (PST Zone)

Nice To Haves

Secondary education is desired
Understanding of revenue cycle process flow is desired but not required

Responsibilities

Receive & analyze Revenue Variance Reports for West Coast Radnet centers. The Revenue assurance coordinator (RAC) will be responsible for performing an analysis of the data received in reports in order to isolate variances that are in need of further research. This analysis will result in the investigation of the reason for the variance, including identification of front end, back end, and NPD (National payor database) discrepancies
Perform the necessary research on variances within Erad, Billing systems, NPD and other data sources to determine the viability of revenue recovery.
For accounts with potential revenue recovery, notify the appropriate parties to initiate the appellate process of these charges. Provide the teams with information needed to accomplish the re-bill or appeal.
Maintain open dialogue with Reimbursement Operations (RO) personnel and contracting regarding status of open appeals.
Maintain open dialogue and coordinate with leadership & contracting to ensure that payor-initiated modifications; including (but not limited to) fee schedule updates, coding changes, billing issues, and Timely Filing Limit changes are implemented and that payor-related issues are resolved.
Prepare and maintain Revenue Assurance Module (“RAM’) Variance Tables within the NPD for their assigned respective RadNet practices.
Prepare a monthly Dashboard Report of RAM status and results.
Assist in the implementation and roll out of procedures and best practices
Perform duties as assigned by Leadership. These duties may include administrative functions and providing ad hoc information/reports from the RAM of the NPD.
Attend and participate in meetings, seminars, and training as required.