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Outside of the Bay Area, California
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Moses Lake, Washington
Posted: 07-Jan-25
Location: Maitland, Florida
Categories:
Internal Number: 24030862
- Monday - Thursday 8:00am -4:30pm, Friday 8:00am -3:00pm
- Reviews, analyzes and resolves patient (or representative) concerns of an escalated nature. Ensures complete and consistent resolution on all concerns. Research validity of the compliant by reviewing supporting clinical and financial documentation.
- Communicates the resolution effectively to patient (or representative) in a reasonable timeframe (as established by performance standards) and escalates unresolved matters to management.
- Manages escalated calls from Customer Service or internal departments while adhering to HIPAA regulations.
- Manages escalated correspondence via email or mail from Customer Service or internal departments by accurately documenting the receipt and communicating the receipt and resolution timeframe to the sender.
- Communicates in a professional and courteous manner with customers while maintaining call productivity standards as determined by the department. Exudes a high level of patience, understanding and compassion in all communications with customers.
- Performs financial reviews on patient accounts such as charge auditing, billing reviews, estimate, and estimate audits and other financial transaction validation. Evaluates financial transactions with an independent perspective to ensure accurate outcomes.
- Three years of experience in Patient Access, Patient Financial Services or Revenue Integrity
- Experience in handling escalated complaint calls (Preferred)
- Understanding of CCI edits, CPT, HCPCS, ICD CM/PCS, and Revenue Codes (Preferred)
- Knowledge of Registration, HIM Coding, Government, and Managed Care billing rules, coverage, payment, and compliance (Preferred)
The Resolution Coordinator, under general and direct supervision by manager, is part of a central team responsible for escalated patient concerns for Revenue Cycle Financial Operations departments to include Patient Access, Patient Financial Services and Revenue Integrity. Reviews concern with an unbiased perspective by researching and auditing any financial elements such as charges, insurance billing, and other financial transactions. Works with internal and external departments to complete research and assist with resolution and ensures consistent resolution procedures with all concerns and communicates resolution with patient (or representative).
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.