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Revenue Cycle Coverage Validation Representative
Job Details
- Job Ref:
- 10034176
- Location:
- Irwindale, CA
- Category:
- Billing & Coding
- Job Type:
- Full-time
- Shift:
- Days
- Pay Rate:
- $22.84 - $30.67 per hour
Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today.
As a successful candidate, you will:
Responsible for daily management of registration and insurance related errors in the following EMR modules:
Charge Review
Claim Edit
Follow Up
Retro Review
Remittance
Registration and coverage validation for all new COH patients received via manual charge capture process.
As requested by internal departments, re-verify insurance information and/or coordination of benefits, to confirm eligibility and coverage via payors website or phone call.
Notifies other pertinent COH staff regarding health care coverage changes for billing correction purposes, while maintaining a positive and collaborative manner interactions with colleagues and others.
Responds timely and accurately to all incoming correspondence from payors, patients, and other COH departments.
Reports trends related to system and/or workflow issues to management team, in an effort to identify root cause and resolution.
Initiate recommendations and take action, when appropriate, in resolving complex patient account issues related to coverage/eligibility.
Collaborates with Revenue Cycle Collectors for submission of corrected claims, and/or communicates with Refund Clerks for payment recoupment, and/or completes Registration for manual charge entry.
Works independently and is able to organize and prioritize workload with limited to no supervision.
Qualifications
Your qualifications should include:
High school diploma
Two (2) to five (5) years of experience in a hospital, medical group or Independent Practice Association (IPA).
Has thorough knowledge of HMO, PPO, POS coverage rules.
Medical terminology and EMR experience
Preferably: Experience with medical groups or Independent Practice Associations (IPA) with specific knowledge of medical EOBs/ERAs/HCFA
City of Hope employees pay is based on the following criteria: work experience, qualifications, and work location.
City of Hope is an equal opportunity employer. To learn more about our Comprehensive Benefits, please CLICK HERE.
Additional Information:
This position is represented by a collective bargaining agreement.