SBO Reimbursement Coordinator

Coordinator SBO Reimbursement This position is responsible for building and maintaining the EHR contract modules in Epic for the Single Billing Office (SBO) at Bay Area Hospital. The coordinator is responsible for system build, monitoring and working claim variances and collaborating with payers to resolve reimbursement related issues. This position also manages payer plan records and remit code mapping in collaboration with the other Community Connect partners.
** EXPECTATION FOR ALL EMPLOYEES
** Support the organization’s mission, vision and values by adhering to the behavioral standards of Bay Area Hospital.  Comply with all laws and regulations affecting Bay Area Hospital.  Be familiar with and adhere to the Code of Conduct and support the Bay Area Hospital Compliance Program.  Effective communication skills and the ability to work effectively with people from various backgrounds are critical.
** POSITION SUMMARY
** This position is responsible for building and maintaining the EHR contract modules in Epic for the Single Billing Office (SBO) at Bay Area Hospital. The coordinator is responsible for system build, monitoring and working claim variances, and collaborating with payers to resolve reimbursement related issues. This position also manages payer plan records and remit code mapping in collaboration with the other Community Connect partners.
** PRINCIPLE DUTIES AND RESPONSIBILITIES
*** Accurately interprets contract reimbursement rates and methodology for build purposes
* Builds and customizes payer plan specific contracts, including various reimbursement methodologies within Epic
* Ensures adequate testing, quality assurance, and documentation of contract build in Epic
* Responsible for tracking contract renewals and amendments
* Performs continual maintenance and updating of existing contracts to reflect current reimbursement rates and methodologies; builds new contracts as needed
* Performs ongoing testing and corrects build errors based on feedback from end users
* Works collaboratively with payers and departments to resolve errors, issues and disputes
* Conducts audits and completes testing of estimated contractual reimbursement
* Responsible for facility, clearinghouse payer and remittance enrollments
* Works bad debt file sent from IT on a monthly basis
* Works low yield accounts from accounting on a monthly basis
* Compiles daily, weekly and monthly statistical reports necessary for successful management of Revenue Cycle Operations and AR Management
* Evaluates material variances and trends to identify and resolve root causes
* Trends professional fee variances and works directly with health plans to resolve issues
* Prepares analysis related to the financial performance of existing payer contracts in order to identify opportunities for improvement and recommend areas for improvement
* Supports payer contracting proposed negotiations by modeling payor contracts to identify effective rate proposals
* Works collaboratively with other revenue cycle and hospital departments, external agencies, vendors, payers and Community Connect partners, communicating effectively in both written and verbal formats with staff, peers, all levels of management, and all encounters both inside and outside the organization
* Provides oversight, prioritizes workflow and monitors performance to support key performance indicators
* Collaborates with Patient Access, HIM, Revenue Integrity and Contract Management to support revenue cycle functions and identify opportunities for improvement; implements performance improvement plans
* Promotes and supports the achievement of organizational goals and revenue cycle objectives
* Provides and promotes professional, efficient and congenial customer service through all…