Revenue Assurance Coordinator

Responsibilities

• & Analyze Revenue Variance Reports for West Coast Radnet centers.
• Perform an analysis of the data received in reports to isolate variances that are in need of further research.
• Investigate the reason for the variance, including identification of front end, back end, and NPD (National payor database) discrepancies.
• Necessary research on variances within Erad, Billing systems, NPD and other data sources to determine the viability of revenue recovery.
• Notify the appropriate parties to initiate the appellate process of these charges for accounts with potential revenue recovery.
• 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.
• Affirm duties as assigned by Leadership, which 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.

Qualifications

• High school diploma required, secondary education is desired.
• 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.
• Understanding of revenue cycle process flow is desired but not required.
• 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.