Revenue Integrity Coordinator

About This Role

The Revenue Integrity Coordinator provides essential support to the National RCM Strategy team by meticulously reviewing claims submitted to payers/insurance companies, ensuring accurate and timely processing of patient accounts within a remote work environment.

Responsibilities

• Perform claim level responsibilities after national trends have been identified and root caused
• Maintain current information on correct and lawful practices for billing payers
• Take claim level actions to submit corrected claims to payers for reconsideration
• Conduct posting review or actions to resubmit claims to a payer as needed
• Verify patient demographic information regarding insurance status and coordination of benefits (COB)
• Review Electronic Remittance Advices (ERA's) and understand charges, expected allowable, and actual allowable

Requirements

• High school diploma or GED equivalent
• 1+ year of experience in a medical billing role
• Understanding of EAP and Behavioral Health carve out plans
• Understanding of CPT, modifiers, Mental Health provider types and how each impact reimbursement
• Understanding of associated privacy legislation related to healthcare information, i.e., HIPAA
• Strong attention to detail
• Legally authorized to be employed in the United States

Qualifications

• High school diploma or GED equivalent required
• 1+ year of experience in a medical billing role

Nice to Have

• 2+ years Behavioral Health/Mental Health space experience
• Previous experience with an electronic medical/health record, preferably AdvancedMD

Skills

* Required skills

Benefits