Revenue Cycle Coordinator III

Provides oversight in the research and resolution of member-related eligibility and billing complaints from internal customers and governing entities.

Responsibilities

• Utilize key accounts receivable and reporting experience and knowledge to ensure timely and accurate recording and reporting of accounts receivable activity
• Provide support to Revenue Cycle Specialists in the research and resolution of member complaints
• Serve as a subject matter expert (SME) for eligibility and billing processes and procedures
• Ensure full resolution of consumer complaint cases submitted by governing entities within regulatory timeframes and defined requirements
• Complete and thoroughly document all issues
• Identify irregular trends; work with other areas as appropriate to identify root causes and take appropriate steps for resolution
• Develop and maintain an in-depth knowledge of the company’s business and regulatory environments
• Make appropriate changes to ensure compliance with MAR, regulatory, and other organization requirements
• Collaborate with management to correct deficiencies in SLA and quality
• Participate in ongoing development of new products and technologies
• Responsible for the development of training for new products and technologies
• Develop and teach others using standard operating procedures and training tools
• Participate in Readiness Reviews and desk audits with State and Federal partners
• Assist with the completion of required reporting
• Ensure all HIPAA and State requirements/regulations are adhered to at all times
• Ad-hoc and free interchange with all departments, managers, and director-level personnel
• Perform any other job duties as requested

Requirements

• Associate Degree in business, finance, or related field or equivalent years of relevant work experience is required
• Bachelor's Degree is preferred
• Minimum of four (4) years of experience in billing, customer service, or claims is required
• Minimum of one (1) year experience in Revenue Cycle Operations required
• Managed care or healthcare experience is preferred
• Enrollment, billing, finance, or data analysis experience is preferred

Skills

• Strong interpersonal skills
• Ability to lead and direct the work of others
• Customer service oriented
• Demonstrates decision-making and analytical/problem-solving skills to perform a variety of complicated tasks
• Attention to detail
• Possesses critical thinking/listening skills
• Ability to write comprehensive statements using proper grammar and sentence structure
• Intermediate proficiency in Microsoft Office Suite to include Word, Excel, and PowerPoint
• Training/teaching skills
• Ability to work with others and independently
• Wide degree of creativity and latitude (independent judgment) is required
• Relies on extensive experience and judgment to plan and accomplish goals
• Excellent written and verbal communication skills
• Ability to develop, prioritize, and accomplish goals
• Public speaking skills
• Ability to work in a fast-paced and constantly changing environment

Working Conditions

General office environment; may be required to sit or stand for extended periods of time.

Pay

$47,400.00 - $76,000.00

Benefits

In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.