What are the responsibilities and job description for the Revenue Cycle Coordinator position at North Mississippi Medical Center System?
Tupelo
BUSINESS SERV-BILLI
Full Time - Day
At North Mississippi Health Services, our mission is to “continuously improve the health of the people of our region.” We aim to “provide the best patient and family-centered care and health services in America.” We believe that fulfilling our mission and vision calls us to embrace the best people who form incredible connections with our patients and families. We take pride in celebrating everything that makes you unique—your talents, perspectives, and passions. At North Mississippi Health Services, we believe in connecting your passion with a purpose. You know what connected feels like when you are part of our team. #WhatConnectsYou
**Billing & Follow Up:** * Process Billing by receiving, interpreting, processing, and submitting through various edits to third party payors billing electronically and hard copy format. * Billing follow up by contacting third party payers or accessing payer websites/provider portals to determine payment expectation and resolve any problem on the claim. * Information communications and processing by interpreting and processing third party payor and patient inquiries in an accurate and timely manner to expedite payment. **Denial Management:** * Manage denial receivable to resolve accounts * Develops strategy for appeal, appeal follow-up and/or reprocessing accounts * Analyze denials to determine reason they occurred * Identifies trends and reports significant and recurring issues along with possible solutions to Denials Management Supervisor and Billing Manager * Takes corrective action through systematic and procedural development to reduce or eliminate payment issues **Contract Management:** * Familiarity with payer methodologies and the ability to communicate with NMHS staff * Manage paid claims to resolve underpaid accounts * Develops strategy for appeal, appeal follow-up and/or reprocessing accounts * Analyze underpayments to determine reason they occurred * Identifies trends and reports significant and recurring issues along with possible solutions to the Denials and Underpayment manager. **Communication:** * Professionally and effectively communicates with third party carriers, vendors, and hospital contacts to promote contractual compliance **Liaison:** * Contacts insurance companies regarding denial, underpayments or rejection issues * Serves as liaison between payers and hospital departments/physician offices or patients in resolving denials and/or underpayment issues **Reporting:** * Assists in preparation of monthly denial reports and other denial reports as requested * Assists in preparation of monthly variance reports and other variance reports as requested. **Regulation**: * Adheres to NMHS/NMMC Policies/Procedures/Guidelines. Complies with applicable Local/State/Federal policies/procedures/guideline/regulations/laws/statues. Job Knowledge: * High School Diploma or equivalent required; with a minimum of 2 years Claims, Billing/Follow-Up, or revenue cycle experience preferred. * Experience/knowledge of managed care reimbursement methodology including ICD-10, CPT-4 and/or HCPCS and DRGs, required * Ability to research, analyze and communicate payer trends to identify reimbursement and training issues. * Excellent analytical and problem-solving skills required * Good organizational and communication (written and verbal) skills; required * Computer skills with strong Microsoft Office, Outlook, Third Party Payer websites; preferred * Excellent interpersonal skills; required.
High School Diploma or GED
BUSINESS SERV-BILLI
Full Time - Day
Posting Description
At North Mississippi Health Services, our mission is to “continuously improve the health of the people of our region.” We aim to “provide the best patient and family-centered care and health services in America.” We believe that fulfilling our mission and vision calls us to embrace the best people who form incredible connections with our patients and families. We take pride in celebrating everything that makes you unique—your talents, perspectives, and passions. At North Mississippi Health Services, we believe in connecting your passion with a purpose. You know what connected feels like when you are part of our team. #WhatConnectsYou
Job Description
**Billing & Follow Up:** * Process Billing by receiving, interpreting, processing, and submitting through various edits to third party payors billing electronically and hard copy format. * Billing follow up by contacting third party payers or accessing payer websites/provider portals to determine payment expectation and resolve any problem on the claim. * Information communications and processing by interpreting and processing third party payor and patient inquiries in an accurate and timely manner to expedite payment. **Denial Management:** * Manage denial receivable to resolve accounts * Develops strategy for appeal, appeal follow-up and/or reprocessing accounts * Analyze denials to determine reason they occurred * Identifies trends and reports significant and recurring issues along with possible solutions to Denials Management Supervisor and Billing Manager * Takes corrective action through systematic and procedural development to reduce or eliminate payment issues **Contract Management:** * Familiarity with payer methodologies and the ability to communicate with NMHS staff * Manage paid claims to resolve underpaid accounts * Develops strategy for appeal, appeal follow-up and/or reprocessing accounts * Analyze underpayments to determine reason they occurred * Identifies trends and reports significant and recurring issues along with possible solutions to the Denials and Underpayment manager. **Communication:** * Professionally and effectively communicates with third party carriers, vendors, and hospital contacts to promote contractual compliance **Liaison:** * Contacts insurance companies regarding denial, underpayments or rejection issues * Serves as liaison between payers and hospital departments/physician offices or patients in resolving denials and/or underpayment issues **Reporting:** * Assists in preparation of monthly denial reports and other denial reports as requested * Assists in preparation of monthly variance reports and other variance reports as requested. **Regulation**: * Adheres to NMHS/NMMC Policies/Procedures/Guidelines. Complies with applicable Local/State/Federal policies/procedures/guideline/regulations/laws/statues. Job Knowledge: * High School Diploma or equivalent required; with a minimum of 2 years Claims, Billing/Follow-Up, or revenue cycle experience preferred. * Experience/knowledge of managed care reimbursement methodology including ICD-10, CPT-4 and/or HCPCS and DRGs, required * Ability to research, analyze and communicate payer trends to identify reimbursement and training issues. * Excellent analytical and problem-solving skills required * Good organizational and communication (written and verbal) skills; required * Computer skills with strong Microsoft Office, Outlook, Third Party Payer websites; preferred * Excellent interpersonal skills; required.
Requirements:
Licenses
You must have the following licenses to apply:Education
You must have the following education to apply:High School Diploma or GED
