Revenue Cycle Operations Project Coordinator

Responsibilities

Job Summary

The Revenue Cycle Project Coordinator is responsible for identifying trends, finding the root cause of the issue and reaching resolution. Provides strong analytic assessment, reporting and operational support on all aspects of the revenue cycle and research operations. In addition, performs efficient and timely processing of services for follow up, complying with contractual filing and appealing of processes at all times, identifying procedural roadblocks, following all team policies, related procedures, and all compliance plan standards.

Essential Duties and Responsibilities

• Identify potential areas of affected reimbursement, and create projects to recover all revenues.

• Monitor projects progression through the defined workflow and address potential issues.

• Measure and report on project performance.

• Develop a project plan for each project that will establish project timelines, tasks and milestones.

• Enhance the ability to increase revenue through targeted claims analysis, identifying systematic errors that affect revenue.

• Monitor on going performance of revenue cycle results through use of key performance indicators.

• Communicating and coordinating with representatives from various Managed Care payers on a routine basis.

• Works collaboratively with all departments within Revenue Cycle Operations to communicate potential factors impacting revenue.

• Identify revenue cycle trends to determine root cause and potential improvement opportunities.

• Proficiency in health care and payer guidelines as it pertains to billing and reimbursement.

• Advises management on matters effecting the revenue cycle operations and recommends enhancements and remedial efforts.

• Prepares reports and presentations.

• Work with AR reports to identify problems on accounts, research accounts/trends and take appropriate actions to promote reimbursement, bill primary and secondary carriers for services provided, and collect on past due accounts.

• Research account requests for additional information such as referrals, scripts, medical reports, and /or call hospitals.

• Efficiently and timely processes of services for follow up.

• Work EOBs to follow up on rejected claims and appeal denial; develop and track written correspondence.

• Work with edit reports to identify problems with transmission claims.

• Other duties as assigned.

PLEASE NOTE: This is not an exhaustive list of all duties, responsibilities and requirements of the position described above. Other functions may be assigned and management retains the right to add or change duties at any time.

Minimum Qualifications, Education and Experience

• Knowledge of medical terminology and a working knowledge of different types of insurance plans.

• Strong Managed Care experience.

• Proficient excel experience, including pivoting and manipulating the data, creating visuals, such as graph and charts to identify trends.

• Ability to type and have a general computer aptitude. Must be able to maintain professional judgment.

• Dependable, energetic, and ability to multitask.

• Must be detail-oriented and organized, with good analytical and problem solving ability.

• Notable client service, communication, presentation and relationship building skills required.

• Ability to function independently and as a team player in a fast-paced environment required.

• Must have strong written and verbal communication skills.

• Ability to excel with change and respond appropriately even in challenging situations.

• Demonstrated ability to use PCs, Microsoft Office suite, and general office equipment (i.e. printers, copy machine, FAX machine, etc.) required.

• Minimum of 1 year of billing or follow-up experience.

• High School diploma or GED required.

Quality Standards

• Communicates, cooperates, and consistently functions professionally and harmoniously with all levels of supervision, co- workers, patients, visitors, and vendors.

• Demonstrates initiative, personal awareness, professionalism and integrity, and exercises confidentiality in all areas of performance.

• Follows all local, state and federal laws concerning employment to include but not limited to: I-9, Harassment, EEOC, Civil rights and ADA.

• Follows OSHA regulations, RadNet and site protocols, policies and procedures.

• Follows HIPAA, compliance, privacy, safety and confidentiality standards at all times.

• Practices universal safety precautions.

• Promotes good public relations on the phone and in person.

• Adapts and is willing to learn new tasks, methods, and systems.

• Reports to work regularly as scheduled; consistently punctual with respect to working hours, meal and rest breaks, and maintains satisfactory personal attendance in accordance with RadNet guidelines.

• Consistently adheres to the time management policies and procedures.

• Completes job responsibilities in a quality and timely manner.

Physical Demands

This position often requires sitting, standing, walking, bending, twisting reaching with hands and arms, using hands and fingers, handling, constant talking, and hearing. Visual acuity is required to read computer screens and written materials. Also, must be able to lift over 10 pounds, occasionally.