Revenue Cycle Coordinator II

Modivcare

2d • $16 - $22 • Onsite

About The Position

This position is responsible for billing effectively and efficiently to facilitate prompt payment for services via billing systems and developing collaborative relationships with payor’s billing departments. This role will be able to perform all of the following tasks: verifying client eligibility, monthly claim/invoice submissions, resubmissions or back billing, resolve denied or rejected claims, including researching accounts, analyzing EOBs, and interacting with insurance companies and government payors. This role utilizes the phone system application by logging in and setting a status of ready to manage incoming phone calls by responding to request and assisting with inquiries. Accesses multiple web portals to identify and research eligibility, collect needed information to ensure timely processing of electronic, portal and invoiced claims. Follows revenue cycle from charge creation through resolution of outstanding AR. Verifies eligibility when required prior to billing payers and documents insurance verification. Assumes responsibility for timely and accurate invoices submission, including generating monthly charges and transmission of EDI claims and invoices Investigates and resolves claim rejections and denials via Clearinghouse or payer portals. Utilizes payer portals or contact payers as needed for claim corrections and/or missing information. Adds and understands specific data such as modifiers, payer specific information, including authorization criteria, CPT and ICD-10 coding. Applies corrections to patient demographics, charges, adjustments and payments or when needed forwards to the appropriate department for correction. Works through reporting cards and tickets assigned through company applications. Works rejection and denial workgroups for timely review and resubmission of EDI claims. Resolves problems by clarifying issues, researching potential solutions, helping to implement changes to maximize timely and complete reimbursement, and escalating unresolved issues. Utilizes multiple system applications daily to work through assigned inventory Identifies and documents any payer issues and communicate with RCM leadership. Maintains KPI and quality goals. Performs resubmission projects and additional daily reports. Participate in other projects or duties as assigned. Occasional business travel may be required.

Requirements

• High School Diploma required
• One (1) plus years of experience in healthcare revenue cycle management or a related field. Or equivalent combination of education and/or experience.
• Knowledge of portal, invoice, and EDI billing methods
• Self-motivation and the ability to work independently and with teams
• Proficient in the use of Word, Excel, Outlook, and PowerPoint
• Excellent verbal and written communication skills
• Proficient in managing multiple tasks as the same time
• Experience with Accounts Receivable follow-up process
• Attention to detail and accuracy in all tasks

Nice To Haves

• Occasional business travel may be required

Responsibilities

• Verifying client eligibility
• Monthly claim/invoice submissions
• Resubmissions or back billing
• Resolve denied or rejected claims, including researching accounts, analyzing EOBs, and interacting with insurance companies and government payors
• Utilizes the phone system application by logging in and setting a status of ready to manage incoming phone calls by responding to request and assisting with inquiries
• Accesses multiple web portals to identify and research eligibility, collect needed information to ensure timely processing of electronic, portal and invoiced claims
• Follows revenue cycle from charge creation through resolution of outstanding AR
• Verifies eligibility when required prior to billing payers and documents insurance verification
• Assumes responsibility for timely and accurate invoices submission, including generating monthly charges and transmission of EDI claims and invoices
• Investigates and resolves claim rejections and denials via Clearinghouse or payer portals
• Utilizes payer portals or contact payers as needed for claim corrections and/or missing information
• Adds and understands specific data such as modifiers, payer specific information, including authorization criteria, CPT and ICD-10 coding
• Applies corrections to patient demographics, charges, adjustments and payments or when needed forwards to the appropriate department for correction
• Works through reporting cards and tickets assigned through company applications
• Works rejection and denial workgroups for timely review and resubmission of EDI claims
• Resolves problems by clarifying issues, researching potential solutions, helping to implement changes to maximize timely and complete reimbursement, and escalating unresolved issues
• Utilizes multiple system applications daily to work through assigned inventory
• Identifies and documents any payer issues and communicate with RCM leadership
• Maintains KPI and quality goals
• Performs resubmission projects and additional daily reports
• Participate in other projects or duties as assigned

Benefits

• Medical, Dental, and Vision insurance
• Employer Paid Basic Life Insurance and AD&D
• Voluntary Life Insurance (Employee/Spouse/Child)
• Health Care and Dependent Care Flexible Spending Accounts
• Pre-Tax and Post --Tax Commuter and Parking Benefits
• 401(k) Retirement Savings Plan with Company Match
• Paid Time Off
• Paid Parental Leave
• Short-Term and Long-Term Disability
• Tuition Reimbursement
• Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED