Revenue Cycle Coordinator III

CareSource; Dayton (OH); On-site; USD 47,400 - 76,000; Full time

Job summary

CareSource is seeking a Revenue Cycle Coordinator III to oversee the research and resolution of member-related eligibility and billing complaints. The role supports Revenue Cycle Specialists and acts as a subject matter expert for eligibility and billing.

The position requires strong AR, billing, and customer service experience, with a focus on regulatory timelines and documentation. A related Associate degree is required and a Bachelor's is preferred.

Qualifications

• Associate degree in business, finance, or related field required.
• Bachelor’s degree preferred.
• Minimum four years in billing, customer service, or claims.

Responsibilities

• Oversee research and resolution of member-related eligibility and billing complaints.
• Support Revenue Cycle Specialists in investigations and resolutions.
• Serve as SME for eligibility and billing processes and procedures.
• Ensure timely regulatory-compliant resolution of complaint cases.

Skills

Accounts receivable

Billing

Customer service

Analytical skills

MS Office

Education

Associate degree in business/related field

Bachelor’s degree preferred

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Job description

Job Summary

The Revenue Cycle Coordinator III is responsible for providing oversight in the research and resolution of member-related eligibility and billing complaints from internal customers and governing entities.

Essential Functions

• 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.
• 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.

Education and Experience

• 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.

Competencies, Knowledge and 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.

Licensure and Certification

None

Working Conditions

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

Compensation

Hourly: $47,400.00 - $76,000.00. In addition to base compensation, you may qualify for a bonus tied to company and individual performance.

Equal Opportunity

CareSource is an Equal Opportunity Employer.