Revenue Cycle Coordinator IV

Rochester, NY

Responsibilities

Job Summary :

The Revenue Cycle Coordinator IV is responsible for monitoring, reviewing and resolving system billing edits/Stop bills for unbilled hospital accounts that require intervention from PFS prior to billing. Assures edits are resolved timely through an expediated review and claim submission to payers to prevent the loss of reimbursement, reduce overall AR and days in AR.

Additionally, the Revenue Cycle Coordinator IV reviews and monitors unresolved edits from non-PFS departments to assure timely submission of unbilled claims.

This position requires flexibility and the ability to function in an evolving and ever-changing environment. The Lead AR Coordinator serves as a liaison between Patient Financial Services and other hospital/professional departments regarding unbilled accounts.

Supervision and Direction Exercised:

This position performs under the general direction of the Manager, with significant latitude for independent initiative and judgment.

Key functions/responsibilities:

Responsibilities include, but are not limited to:

35% Resolve accounts on Epic Edit Work ques utilizing accepted billing guidelines.

  • Research edits and utilize knowledge of billing requirements, Epic workflows and specific payor requirements to resolve edits and assures claims are released to bill timely

  • Take appropriate system actions on accounts based on billing guidelines, record research as well as any interaction needed with the clinical department to resolved the edit/stop bill

25% Daily Tracking/Monthly reporting

  • Track daily trends in remaining edits/stop bills by Workques (WQ) to observe trends and achievements in reducing WQ outstanding volumes

  • Report worked and resolved edits/stop bills, highlighting any new edits, trends or departments with backlogs for that time period to the Manager to provide feedback to the appropriate URMC or HH departments to assist with operational improvements.

  • Track monthly trends in reduction of specific write-offs codes to assure processes and communication are effective in reducing these write-offs.

20% Enhancement of processes and procedures in unbilled accounts

  • Provide on-going documentation of proposed changes to processes both within PFS and with other hospital departments to support reduction of edits from being created by consistently evaluating root causes of errors which cause claims to be delayed

15% Act as the liaison between PFS and PFS Systems Group to investigate and resolve new edits or negative trends (increases) in specific edits

5% Utilize in-depth knowledge of payer contracts and reimbursement methodologies to address credit balances as needed

Qualifications:

Associates degree in business field and 4 – 5 years’ experience in hospital billing, accounting, coding and/or customer service or an equivalent combination of education and experience.

Note: This document describes typical duties and responsibilities and is not intended to limit managers from assigning other work as required.

The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.

Pay Range

Pay Range: $21.50 - $29.03 Hourly

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

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Location: Strong Memorial Hospital
Full/Part Time: Full-Time
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