What are the responsibilities and job description for the Compliance & Appeals Coord. position at MemorialCare Shared Services?
Title: Compliance & Appeals Coord.
Location: Fountain Valley
Department: Compliance
Status: Full-time
Shift: Days (Hybrid)
Pay Range: $29.76/hr - $43.16/hr
MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.
Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.
Position Summary
Working under the direction of the Director of Compliance with minimal supervision, the Compliance and Appeals Coordinator is primarily responsible for record keeping of government appeals and deadlines, coordinating with outside vendors for appeals, reconciliation of appeal databases to ensure accuracy and timeliness, and assists in Compliance related audits and investigations.
Essential Functions and Responsibilities of the Job
1. Must have understanding and familiarity with healthcare privacy and security laws, regulations and standards.
2. General knowledge of government appeals process and deadline management.
3. Understanding of many complex and varying guides, systems, regulations and tools.
4. Able to use critical thinking skills to manage an ever-evolving process that includes financial, clinical and medical/legal components.
5. Be at work and be on time.
6. Follow company policies, procedures and directives.
7. Interact in a positive and constructive manner.
8. Prioritize and multitask.
*Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.
Qualifications:
Experience
Clinical or patient accounting background with a fundamental knowledge of the Revenue Cycle Process which includes Patient Access, Case Management/Utilization Review, Charge Capture, HIM, Patient Accounting for minimum of 3 years preferred. Must have demonstrated skills in analytical and critical thinking, be detail oriented, able to easily navigate software systems, and troubleshoot system issues independently. Possess proficient Microsoft Excel skills. Positive work ethic, self-motivated individual.
Minimum 1-year previous experience working in health care setting
Education
Bachelors’ degree in a healthcare related field is preferred
Salary : $30 - $43
