Revenue Cycle Coordinator

Under the supervision of the Executive Director and a third-party consulting firm, the Revenue Cycle Coordinator’s primary responsibilities are to communicate, coordinate and facilitate with remote outsourcing company requests and needs for efficient and timely completion of assigned revenue cycle workload. In addition, apply patient visit payments, work with clinic management and outsourcing company for the completion of accurate encounter entry for timely submission of encounter data for claims processing.

The Revenue Cycle Coordinator must perform duties in line with the Health Insurance Portability and Accountability Act (HIPAA). It is the responsibility of the Revenue Cycle Coordinator to know his/her limitations and abide by the regulatory standards. This role requires excellent interpersonal and customer service skills, must be courteous and helpful,and possess the ability to meet and speak with the public as the“first contact”of the clinic while aligning his/her duties with Sycuan Medical Dental Center values.

Essential Duties and Responsibilities:

• Administrative Functions:
• Must become proficient in the use of the Next Gen EHR practice management software system,including learning and applying new functionality as needed.
• Have knowledge of payer billing requirements {Medi Cal, Medicare, Patient Eligibility Payment Programs,and Commercial Insurances).
• Scanning of documentation, EOBs, and any other requested information to SharePoint via process and protocols.
• Obtain all remits for posting – i.e. Download from websites, ERA files, etc.
• Maintain deposit reconciliation with finance and keeping record of reconciliation log.
• Post all insurance and patient payments and adjustments in practice management system.
• Coordinating/Resolving issues that hold up claim approval – claim issues that cannot be handled off-site – i.e. registration updates.
• Coordinating/Resolving issues that hold up account adjudication – denial/aged issues that cannot be handled off-site – i.e. missing EOBs.
• Coordinating with clinic/dental staff to resolve deficiencies.
• Prepare and send patient statements monthly and maintain regular schedule for sending. out billing statements in accordance with the Financial Policies and Procedures.
• Patient phone calls regarding statements.
• Create patient payment plans when needed.
• Maintainandprocess for review of all billing statements which arereturnedtosender.
  
  Utilize public records and otherresourcesto make best effort to obtain accurate billing addresses.
• Assist billing department outsource company personnel as necessary..
• Answers all incoming calls within 3 rings and makes patients calls in a courteous and professional manner.
• Willingness to help and maintain professional relationships with coworkers.
• Performs other duties as needed.
• Attends all staff meetings.
• Observes and acknowledges all SMDC policies and procedures.
• Always greets patients, visitors, and providers in a courteous and respectful manner; responds to patients with empathy and positive interpersonal skills; consistently handles all requests in a positive manner.
• Receive and sort all incoming mail from internal and external sources to include but not limited to US Post Office and other courier services.
• Accounts Receivable: responsible for AP email, print and code all invoices to be paid before sending to Tribal Accounting, and contact vendors in regards to discrepancies, questions or requests.
• Responsible for the eFax email account. Distribute all incoming faxes to appropriate Clinic Dept.
• Responsible for Fire Department billing workflow; daily charges, daily claims and weekly statements.
• Handles reimbursements from Correct Care, Medi-Cal, Molina and AMR.
• Submit quarterly reports to DHCS for GEMT QAF.
• Responsible for accounts receivables.
• Poi…