Job Description

Job Description

Job Title: Revenue Cycle Coordinator

Department/Location: Revenue Cycle Management

Reports to: Sr. Manager, Revenue Cycle ****

FLSA Status: Non-Exempt

Direct Reports: None

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Company Overview**

At Consensus Health, we believe better healthcare begins with a community of strong, independent providers delivering high quality, compassionate patient care with improved outcomes. As New Jersey’s fastest growing independent medical group, Consensus Health offers full clinical and operational integration with our value-based care programs, enabling providers to transform the healthcare delivery experience. In addition, Consensus Health owns and manages New Jersey’s oldest Independent Physician Association (“IPA”) with over 1,000 providers throughout the state. At Consensus Health we believe in fostering an environment of collaboration, participation, and respect. A cornerstone of that belief is a commitment to attracting talented and dedicated team members who work together for the common purpose of providing clinical excellence.

Consensus is committed to attracting, developing, and retaining talented people who are passionate about helping physicians and their staff deliver better care to patients and whose values align with ours. We empower our employees to bring the right solutions forward to strengthen the relationship between providers and patients and ensure that our staff are well served.

Position Summary

The Revenue Cycle Coordinator will be responsible for supporting management in maintaining, improving, processing, and evaluating the billing and collection of accounts receivable for the Medical Group and/or resolve complex payer issues to completion daily. This may encompass working the receivable of multiple practices and will comprise of the receivable of multiple third-party payers, as well as, supporting management in the overall execution of Revenue Cycle collection duties.

Duties and Responsibilities

The duties include, but are not limited to:

• Complete A/R resolution, corrected claims, appeals
• Maintains data in billing management system, i.e. updating current and adding new demographic information, and ensures that documentation entered is accurate and complete.
• Interacts / communicates effectively with various department staff and assists customer service inquires both internally and externally.
• Contacting payors for claims status and dispute resolution
• Charge capture, collections processing and payment posting
• May perform other duties as assigned.

Qualifications or Education, Training and Experience

• High School Diploma or GED required
• Minimum 3-5 years’ experience in physician billing
• Experience working in a physician practice preferred
• athenaNet experience preferred
• Detail oriented
• Working knowledge of Microsoft Office Word and Excel

Knowledge and Skills/Expected Competencies

• Knowledge of accounting, healthcare, and general office procedures, preferred.

• Working knowledge of collection processes and insurance verification and pre-certification processes.

• Requires ability to understand, interpret, evaluate, and resolve basic customer service issues.

• Intermediate knowledge of accounting principles which directly impacts the accounts receivable that may include debit and credit transactions; charge transfers; contractual allowances and adjustments and financial class changes.

• Knowledge of the state and federal reimbursement and regulatory guidelines to ensure compliance with State regulations regarding patient and insurance billing issues, preferred.

• Knowledge of medical terminology

• Requires knowledge of common revenue cycle accounts receivable terms, common business practices, and statute of limitations as it pertains to billing, appeals, payer requests, payments, retractions, and EOBs.

• Requires knowledge of billing, collection, and telecommunications software

• Understands HCPC and/or CPT coding issues that could impact a claim.

• Requires knowledge of up to date HIPAA and HITECH rules and regulations.

• Demonstrates ability to assist in mentoring others in regard to the department’s payers and revenue cycle processes.

• Ability to work the receivable of multiple facilities with experience, knowledge, and skills that are transferable to other tasks and assignments.

• Understands common terms used daily in carrying out tasks.