Coordinator- Revenue Cycle

North Mississippi Medical Center, Inc; United States; Sur place; USD 45 000 - 65 000; Plein temps

Résumé du poste

North Mississippi Health Services is seeking a Revenue Cycle Coordinator to optimize bill processing and denial management across payer contracts. You will support timely revenue flow, analyze denials, and coordinate with payers, vendors, and hospital staff to improve payment capture.

The role requires strong analytical, organizational, and communication skills, with experience in billing follow-up, contract management, and reporting.

Qualifications

• Ability to research, analyze and communicate payer trends to identify reimbursement and training issues; required
• Excellent analytical and problem-solving skills
• Good organizational and communication (written and verbal) skills
• Excellent interpersonal skills
• Must professionally and effectively communicate with third party carriers, vendors, and hospital contacts to promote contractual compliance
• Must provide input and help design payer report cards in conjunction with contracting, managed care, and other revenue cycle departments
• Must participate as member of the Denials Committee
• Must conduct training sessions with Billing and Follow-up staff as needed
• Must have effective negotiating skills including the ability to resolve difficult claims issues
• Must be able to gather and share information with knowledge, tact, and diplomacy
• Must have extensive contact with: patients, payers, physician office staff, coding staff, Credentialing, Case Management, various Department heads, and all staff within the department

Responsabilités

• Billing & Follow Up: Processes billing by receiving, interpreting, processing, and submitting through edits to third party payors electronically and in hard copy.
• Billing follow up: contact payers or use portals to determine payment expectations and resolve issues.
• Denial Management: manage denial receivable and develop strategy for appeals and reprocessing.
• Contract Management: communicate with NMHS staff and manage paid claims to resolve underpayments; analyze underpayments.
• Communication: communicate with third party carriers, vendors, and hospital contacts to promote contractual compliance.
• Liaison: contact insurance companies regarding denial, underpayments or rejection issues; act as liaison between payers and hospital departments.
• Reporting: assist in preparation of monthly denial and variance reports.
• Regulation: adhere to policies and comply with local/state/federal regulations.

Connaissances

Payer trends analysis

Analytical problem-solving

Organizational and communication

Interpersonal skills

Negotiation skills

Training ability

Stakeholder management

Outils

Microsoft Office

Outlook

Payer portals

Description du poste

We believe a career is more than just a career - it's a calling. Our teammates' \"True North\" is what calls them to health care; it's their passion. At North Mississippi Health Services, we believe in helping you leverage and connect that passion with a much greater purpose that impacts people you know and love.

Department:

10009220 Business Office Billing

Job Description:

The Revenue Cycle Coordinator at North Mississippi Health Services is responsible for supporting timely and effective Revenue Cycle flow to facilitate payment capture through bill processing and denial and contract management. This position engages strong technical knowledge, as well as organizational and communication skills to manage follow up and coordination with payers, vendors, and staff members to resolve claim issues, facilitate contractual compliance, generate reporting, analyze opportunities for improvement, and implement solutions to realize more effective flow and support of payment capture.

JOB FUNCTIONS

Billing & Follow Up:

• - Processes Billing by receiving, interpreting, processing, and submitting through various edits to third party payors billing electronically and hard copy format.


• - Completes Billing follow up by contacting third party payers or accessing payer websites/provider portals to determine payment expectation and resolve any problem on the claim.


• - Facilitates information communications and processing by interpreting and processing third party payor and patient inquiries in an accurate and timely manner to expedite payment.

Denial Management:

• - Manages denial receivable to resolve accounts.


• - Develops strategy for appeal, appeal follow-up and/or reprocessing accounts.


• - Analyzes denials to determine reason they occurred.


• - Identifies trends and reports significant and recurring issues along with possible solutions to Denials Management Supervisor and Billing Manager.


• - Takes corrective action through systematic and procedural development to reduce or eliminate payment issues.

Contract Management:

• - Possesses familiarity with payer methodologies and the ability to communicate with NMHS staff.


• - Manages paid claims to resolve underpaid accounts.


• - Develops strategy for appeal, appeal follow-up and/or reprocessing accounts.


• - Analyzes underpayments to determine reason they occurred.


• - Identifies trends and reports significant and recurring issues along with possible solutions to the Denials and Underpayment manager.

Communication:

• - Professionally and effectively communicates with third party carriers, vendors, and hospital contacts to promote contractual compliance.

Liaison:

• - Contacts insurance companies regarding denial, underpayments or rejection issues.


• - Serves as liaison between payers and hospital departments/physician offices or patients in resolving denials and/or underpayment issues.

Reporting:

• - Assists in preparation of monthly denial reports and other denial reports as requested.


• - Assists in preparation of monthly variance reports and other variance reports as requested.

Regulation:

• - Adheres to NMHS/NMMC Policies/Procedures/Guidelines.


• - Complies with applicable Local/State/Federal policies/procedures/guideline/regulations/laws/statues.

Knowledge Skills and Abilities

• - Ability to research, analyze and communicate payer trends to identify reimbursement and training issues; required


• - Excellent analytical and problem-solving skills


• - Good organizational and communication (written and verbal) skills


• - Excellent interpersonal skills


• - Computer skills with strong Microsoft Office, Outlook, Third Party Payer websites; preferred


• - Must professionally and effectively communicate with third party carriers, vendors, and hospital contacts to promote contractual compliance and recommend corrective and preventative actions


• - Must provide input and help design payer report cards in conjunction with contracting, managed care, and other revenue cycle departments


• - Must participate as member of the Denials Committee


• - Must conduct training sessions with Billing and Follow-up staff as needed


• - Must have effective negotiating skills including the ability to resolve difficult claims issues


• - Must be able to gather and share information with knowledge, tact, and diplomacy


• - Must have extensive contact with: patients, payers, physician office staff, coding staff, Credentialing, Case Management, various Department heads, and all staff within the department

Physical Demands

• - Standing. Constantly


• - Walking. Frequently


• - Sitting. Rarely


• - Lifting/Carrying. Frequently 50 lbs


• - Pushing/Pulling. Frequently


• - Climbing. occasionally


• - Balancing. occasionally


• - Stooping/Kneeling/Bending. Frequently


• - Reaching/Over Head Work. Fre