Revenue Cycle Coordinator - Ambulatory Surgery Center, Full-time, Days

The Revenue Cycle Coordinator will be responsible for maintaining all essential functions related to the revenue cycle and medical records compliance including, but not limited to account management, insurance verification, and billing/collections. Team members will cross-train within the business office to allow for smooth, fluid systems within the revenue cycle.

• Verifies insurance/coverage for all ASC cases scheduled for surgery within time frame.
• Evaluates medical necessity and medical record documentation requirements (payer specific) prior to procedure or prior to billing to ensure the level of care is reimbursed and/or avoid delays in payment.
• Completes all assigned modules in the ASC’s Practice Management System timely and accurately.
• Understands and has a working knowledge of corporate compliance regarding identity theft, HIPAA, patient rights/responsibilities, regulations related to billing/coding, governing laws related to collections and release of PHI.
• Coordination of patient financial obligations/counsel.
• Billing and denial management
• Responsible for all policy & procedures related to the ASC’s revenue cycle in order to maintain a healthy accounts receivable.
• Responsible for patient and cross-departmental communication.
• Reports all assigned revenue cycle key indicators on the dashboard. Responsible for Financial Outcomes related self-pay AR and bad debt. Responsible for goal setting to achieve positive outcomes.

Minimum Education
 

• High School Diploma or Equivalent Required

Minimum Work Experience
 

• 1-3 years Healthcare customer service experience Required
• Less job experience is required with completed advanced education (Associates, Bachelors, or Masters’ degree

Required Skills, Knowledge and Abilities
 

• Knowledge of Medical terminology; CPT coding and NCCI, ICD 10 CM and HCPCS; Medicare Rules & Regulations related to covered services, billing, ABN and Medical Necessity Requirements (LCD); Medical Records Compliance Request for Reimbursement (Pre & Post Procedure); Coordination of Benefits; Third Payer Medical Policies; Pre-Certification Rules & Authorization Requirements; Fair Debt Collection Act; Worker’s Compensation Rules (Florida & Out of State) and PIP Rules. Understanding Payer Contract Language and Applying Optimum Customer Service. Knowledge of Coordination of Benefits. Billing and Payment Rules.
• Denial Management.
• Logical Math and Computer Skills.