Revenue Cycle Coordinator

Job Title: Revenue Cycle Coordinator                        

Department/Location: Revenue Cycle Management

Reports to: Sr. Manager, Revenue Cycle             

FLSA Status: Non-Exempt

Direct Reports: None

 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.

Physical/Mental Demands and Work Environment

The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Examples of Work Environment

While performing the duties of this job, the employee is regularly required to {Pick from these for example: walk, bend, sit, talk, lift, or hear.} The employee is regularly required to stand, walk and use hands and arms to operate general office equipment (PC, telephone, file cabinets, copier, postage meter, fax machine and printer). The employee may occasionally lift and/or move between 10 and 25 pounds. Specific vision abilities required by this job includes close vision and ability to adjust focus. The employee may need to travel to healthcare practices

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The noise level in the work environment is usually low to moderate.

The Company reserves the right to modify the job description based upon its needs and may require the employee to perform functions beyond those mentioned above. Neither this job description nor any other communication creates an employment contract between the Company and the employee.

Equal Employment 

Our culture encourages individual development, embraces an inclusive environment, rewards innovative excellence and leads New Jersey in provider and patient satisfaction.  Consensus Health values diversity, inclusion, and equity as matters of fairness and effectiveness. We are committed to hiring and retaining a staff that reflects the diversity of the communities we serve, fostering an inclusive working environment where staff of all backgrounds feel welcomed and engaged. 

Consensus Health is an Equal Opportunity Employer and encourages applications from individuals underrepresented in the medical sector, including people of color, and persons with non-traditional work and educational experience.  All who believe they meet the stated qualifications are invited to apply.  

Company Safety

We believe that the best care for our patients starts with the best care for our employees. Consensus Health is committed to proactively creating and maintaining an environment that is safe for our team and patients. Employees are required to wear Personal Protective Equipment (PPE) including face masks, gloves, gowns, and more as appropriate.