Revenue Cycle Coordinator

Stance Health Solutions, Inc•La Crescenta - Montrose, CA

About The Position

Position Overview: The Revenue Cycle Coordinator is responsible for managing the revenue cycle, which is the process of generating, acquiring, and delivering revenue. Key responsibilities include processing and submitting claims to insurance companies and patients, following up on unpaid claims, resolving discrepancies with payers, ensuring timely collection of payments from insurance companies and patients. The Revenue Cycle Specialist is also responsible for submitting and obtaining all necessary documentation to create revenue for insurance companies. RCC is required to understand and interpret payer contracts.

Requirements

Minimum one year of customer service experience
High school diploma or equivalent required
Effective verbal and written skills
Knowledge in all major insurance carrier reimbursement guidelines and eligibility coverage (Medicare, Medi-Cal, Commercial Health Plans)
Able to work in a fast-paced environment, flexible and ability to adapt to changing environment
Strong interpersonal, communication, time management, and organizational skills required
Self-Starter with the ability to work independently
Working knowledge of MS Office

Responsibilities

Meet with Revenue Cycle Supervisor and Director to discuss areas of concern.
Answers questions and provides solutions to Revenue Cycle Management team.
Creates and updates Standard Operating Procedures (SOPs) and Work Aids for both domestic and global revenue cycle teams.
Supports Daily and Weekly Communication of Payer, Product and Process Updates to both domestic and global teams.
Reviews request from team members for updates to payer / system configuration and submits to the appropriate team for system update.
Monitor and report on key performance indicators related to revenue cycle activities, such as claim denial rates, time to payment, and outstanding accounts receivable, to identify areas for improvement.
Work on complex and intricate revenue-related matters.
Supports global team and provides feedback though QA, reviews and huddles.
Monitors work completed by global partners and resolves tasks the global team cannot resolve.
Trains and provides support to domestic and global team members.
Submits price table, payer rule, and system configuration updates to designated team.
Provide feedback to Intake team members on processing errors that have taken place.
Process and submit insurance claims to various payers, ensuring accuracy in coding and billing information to minimize denials and delays.
Review patient accounts to verify correct insurance billing information, update records as necessary, and resolve any discrepancies in patient account balances.
Analyze denied claims to identify denial reasons and perform the necessary follow-up actions including appealing denied claims with appropriate documentation and justification.
Analyze accounts receivable reports and take appropriate action to resolve repetitive denials.
Coordinate with healthcare providers to obtain necessary medical documentation, referrals, or authorizations required for claim processing and reimbursement.
Discusses areas needing improvement with the authorization and CMN departments as needed and offers solutions.
Engage directly with patients to explain their bills, resolve billing inquiries, and set up payment plans for outstanding balances, ensuring a positive customer service experience.
Engage in written communication and schedule meetings with payers to address aging balances.
Compiles and submits projects to insurance companies.
Supports auditors responsible for the production/quality of global team members.