Revenue Integrity Administrative Coordinator

AtlantiCare; Egg Harbor Township (NJ); On-site; USD 30,000 - 45,000; Part time

Benefits offered by this job

Generous PTO

Medical, Prescription Drug, Dental &  

Retirement Plans / 401(k)

Short-Term & Long-Term Disability

Life & AD&D Insurance

Tuition Reimbursement

Flexible Spending Accounts (FSAs)

Wellness Programs

Voluntary Benefits (Pet Insurance)

Job summary

AtlantiCare in New Jersey is seeking a Revenue Integrity Administrative Coordinator to provide administrative coordination for the Utilization Management staff and Revenue Integrity Team. The role focuses on assisting with payer authorizations for hospital stays, coordinating with payers, and utilizing STAR MCCM for approvals and denials.

You will access payer portals daily, transmit clinical information, and document communications in Care Management tools.

Qualifications

• High School Diploma required; Associate degree preferred.
• Minimum 3 years of relevant experience in medical terminology and payer authorization processes.
• Experience with payer portals; strong communication, organization and time-management skills.

Responsibilities

• Provide administrative coordination to Utilization Management and Revenue Integrity teams.
• Assist with obtaining/validating payer authorizations for hospital stays at the correct level of care.
• Access payer portals daily and document payer communications in Care Management Tool.
• Support Veracity denials portal for disputes/appeals when needed.
• Collaborate with Utilization Management staff, Physician Advisor, and Revenue Cycle teams.

Job description

Job Description

POSITION SUMMARY

The Revenue Integrity Administrative Coordinator role provides administrative coordination to the Utilization Management staff and Revenue Integrity Team. This position is primarily responsible for assisting the Utilization Review RN, Physician Advisor, Revenue Integrity Team and HIM records release to obtain/validate authorization from the payers for the patients hospital stays at the appropriate level of care, and to prevent a potentially denied hospital stay. As necessary, this position may also assist in Veracity denials portal to coordinate dispute/appeals for non-paid accounts. Some specific tasks of this role include accessing all payer portal timely, denied and approved accounts, faxing clinical information to the payers and transferring details into STAR MCCM system for approvals and denials. Daily monitoring of various payer portals and submitting the requested information as directed by Utilization Review Coordinators, providing prompt feedback to both the Utilization Review Coordinators and the Physician Advisor if an authorization is not obtained, to establish peer to peer with PA and payor and documenting the various payer communications in the Care Management Tool. This position requires high level IT skills, excel expertise, ability to facilitate multiple payor portals, and navigate share site. This position mandates collaboration/interaction with all Utilization Management staff, regular communication with the Physician Advisor, and ongoing collaboration with some of the Revenue Cycle team. This position requires a strong knowledge of medical terminology and the various payers authorization processes. This position supports organizational goals of providing details to support clean timely compliant claim release and providing quality customer service, participating in performance improvement efforts and demonstrating a commitment to teamwork and cooperation.

QUALIFICATIONS

EDUCATION: High School Diploma required. Associates degree preferred. EXPERIENCE: Minimum 3 years of relevant experience required, with demonstrated acumen in Medical Terminology and payer authorization processes, payer portal use and access. Strong effective communication skills, excellent organizational and time management skills, and flexibility in responding to multiple demands are required. Licenses or Certifications: N/A

PERFORMANCE EXPECTATIONS

Consistently demonstrates the technical and behavioral competencies as established on the Assessment and Evaluation Tool. Drives process improvement to align with clean, timely, compliant claim release and as well as organizational goals. Productivity standards are met in payer portals, MMX, Veracity, MCG etc.

WORK ENVIRONMENT

Office environment with limited exposure to infectious disease, hazardous substances and potential injury. This position requires desk/computer work a majority of the time.

REPORTING RELATIONSHIP

This position reports to department leadership.

Job Details

• Job Schedule: Part time
• Job Shift: Per Diem
• Pay Range: $22.38-$33.57 per hour
• Holidays Required: Yes
• Weekends Required: Yes
• Hrs Per Week: Varies
• Posting Requirement: Post Int & Ext

Benefits

• Generous Paid Time Off (PTO)
• Medical, Prescription Drug, Dental & Vision Insurance
• Retirement Plans / 401(k) with employer contributions
• Short-Term & Long-Term Disability Coverage
• Life & Accidental Death & Dismemberment Insurance
• Tuition Reimbursement to support your educational goals
• Flexible Spending Accounts (FSAs) for healthcare and dependent care
• Wellness Programs to help you thrive
• Voluntary Benefits, including Pet Insurance and more

Benefits offerings may vary based on position and are subject to eligibility requirements.

Join a team that values your well-being and invests in your future.

Pay Transparency

In order to support the Fair Compensation Strategy by the US Govt., HR Dept., clients are required to adhere to "Pay Transparency Law" in impacted states, which mandate employers to list salary ranges in job advertisements and promotions.

AtlantiCare is an Equal Opportunity Employer

Equal employment opportunity, including veterans and individuals with disabilities.