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Healthcare Revenue Assurance Coordinator
2 months ago
Position Summary
Sovah Health is seeking a dedicated professional to oversee and enhance revenue cycle integrity operations. This role involves developing systems to manage medical necessity denials and creating tracking mechanisms to assess financial performance across various service lines, payers, and providers.
Key Responsibilities:
- Document and monitor all RAC and payer audit requests, ensuring compliance with established timelines.
- Manage the submission of medical records and respond to denial and appeal inquiries.
- Communicate RAC findings to essential stakeholders within the organization.
- Coordinate and oversee multiple RAC notifications at different stages of appeal based on received feedback.
- Log and disseminate all government correspondence to relevant parties, maintaining accurate records.
- Collaborate with various departments to enhance processes that ensure efficient billing of hospital claims, addressing any identified issues.
- Educate staff involved in the revenue cycle, preparing training materials and conducting assessments as necessary.
- Work closely with clinical departments, managed care, and business office teams to secure appropriate reimbursements through accurate coding and charging.
- Assist with SOX audits, insurance denial appeals, and address patient billing concerns as required.
- Contribute to the formulation of policies and procedures, ensuring adherence to revenue cycle standards.
- Engage in resolving revenue cycle challenges and refining processes to mitigate future issues.
- Stay updated on current trends and regulatory changes affecting healthcare revenue cycles.
- Verify insurance benefits and obtain necessary precertifications or authorizations.
- Conduct medical necessity checks when applicable.
- Provide support in other registration areas as needed.
About Us:
People are our passion and purpose. At Sovah Health – Martinsville, we value our employees for their unique contributions. Our facility is a licensed 220-bed acute-care hospital offering a wide range of medical specialties, including home health and hospice services, advanced wound care, cardiac rehabilitation, and oncology services.
Why Join Us:
- Comprehensive health benefits (Medical, Dental, Vision) and 401K for full-time employees.
- Generous Paid Time Off and Extended Illness Bank for full-time staff.
- Employee Assistance Program focusing on mental, physical, and financial wellness.
- Tuition reimbursement and assistance for eligible candidates.
- Opportunities for professional development and mentorship.
- And much more...
Minimum Qualifications:
Education: High school diploma or equivalent required; college education or two years of relevant experience preferred.
Skills: Strong critical thinking, decisive judgment, and the ability to work independently in a fast-paced environment. Knowledge of hospital billing processes, insurance practices, and relevant regulations is essential. Proficiency in HCPC/CPT/UB04 coding, excellent communication skills, and strong organizational abilities are required.
Experience: Preferred two years of experience in hospital revenue cycle management. Familiarity with patient accounting systems and billing regulations is necessary.
EEOC Statement: Sovah Health - Martinsville is committed to providing equal employment opportunities for all applicants and employees, adhering to all applicable laws against discrimination.
We are an equal opportunity employer and value diversity in our workforce.