Revenue Cycle Coordinator-Accounts Rec

From primary to specialty care, as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours.

The nature of “coordinator” responsibilities may vary slightly depending on the core job, but generally involves limited oversight over a group of employees that are typically classified in the same core job family. An incumbent performs much the same work as others in the job family, through participation in the day- to-day operations of the work unit, with “coordinator” work. Knowledge of the policies, procedures and equipment applicable to the work unit is required.

Essential Functions 

• Serves as a “coordinator” resource for other staff in their assigned functional unit and assists Supervisor/Manager through the transmission of work instructions and participation in the planning, development, and implementation of new/revised procedures.
• Reviews work to facilitate efficient workflows; assists Supervisor/Manager with hiring interviews and staff orientation/training; and provide feedback on staff performance as requested.
•  Responds to emails and calls from team members/leaders in an organized, accurate and timely manner.
• Explains various billing issues affecting reimbursement, including billing edits, reimbursement methodology, denial trends, and payer regulations or requirements to clinic representatives.
• Provides feedback and training to clinic staff based on examples and/or trends identified in the Revenue Cycle as necessary.
•  Applies knowledge of CMS and other insurance billing guidelines and regulations, payer contracts and reimbursement as well as experience with insurance review to gather additional information, as necessary.
• Identifies trends in denials and billing issues and identifies resolutions accordance with established guidelines.
• Works collaboratively with payers and revenue cycle staff to explain denial or underpayment issues.
• Establishes and maintains a professional relationship with clinics and staff in order to resolve issues.
• Maintains professional telephone and e-mail communications.
• Depending on role and Epic training, may be called upon to support other areas in the Revenue Cycle.
• Communicate audit and production standards and reviews to Revenue Cycle staff to improve proper handling of accounts

Required Education and Experience

• 2 years of Revenue Cycle Experience.
• Knowledge of medical insurance, CPT and ICD codes.
• Knowledge of medical insurance, payer contract, and basic
  medical terminology and abbreviations.
• Ability to understand and apply detailed billing requirements
  and insurance follow-up practices.
• Ability to identify and articulate non-compliance with
  established guidelines and/or regulatory requirements.
• Ability to troubleshoot, understand and/or adapt moderately
  complex oral and or written instructions/guidelines to
  diverse or dissimilar situations.
• Ability to maintain confidentiality of medical records, and to
  use discretion with confidential data and sensitive
  information.