Back to Search New Search

Managed Care Coordinator - Patient Financial Services - Full time

Erlanger Medical Center Chattanooga, TN
Save

Job Description

Description

 
Job Summary:
Assist Denial Coordinator in establishing reasons for underpayments and denials and enacting appropriate corrective actions to prevent future underpayments/denials.  Document processes and monitor implementation to support improved reimbursement.  Maintain current knowledge of all government and commercial payer regulations regarding coverage and restrictions to assure maximum reimbursement.    Review and interpret contractual agreements as well as Tennessee Statutes in order to effectively communicate/implement updates to Patient Financial Services, Patient Access Services, Reimbursement, and Finance Departments.  Serve as a liaison for contractual variances and assist Denial Coordinator in addressing issues with the Managed Care Reimbursement Department.  Utilize the expected reimbursement system (Cost-Flex) for PFS and assign accounts to collectors for further follow-up as appropriate.  Validate Costflex data by using payer fee tables and contractual data, often requiring complex mathematical calculation.   Perform other duties as required to support revenue cycle management.

Education:
Required: 
High School diploma or equivalent

Preferred:
Two year College Degree

Experience:
Required:
Five years experience in a hospital setting working with insurance contracts, follow-up procedures and reimbursement.  Must be organized, have excellent written and verbal communication skills, and manage their time well.  Must have extensive word processing, spreadsheets and database experience as well as be able to work with minimal direct supervision.  
Preferred:

Position Requirement(s): License/Certification/Registration
Required:
Collection Patient Account Representative Certification (CPAR) within 6 months of placement in position.  
Preferred: 

Department Position Summary:
Meet and work with payers in establishing reasons for underpayments and denials and enacting appropriate corrective actions to prevent future underpayments/denials.  Document processes and monitor implementation to support improved reimbursement.  Maintain current knowledge of all government and commercial payer regulations regarding coverage and restrictions to assure maximum reimbursement.   Review and interpret contractual agreements as well as Tennessee Statutes in order to effectively communicate/implement updates to Patient Financial Services, Patient Access Services, Reimbursement, and Finance Departments.  Assist Denial Coordinator by being a liaison for contractual variances and independently address issues with the Managed Care Reimbursement Department.  Utilize the expected reimbursement system (Cost-Flex) for PFS and assign accounts to collectors for further follow-up as appropriate. Validate Costflex data by using payer fee tables and contractual data, often requiring complex mathematical calculation.   Perform other duties as required to support revenue cycle management.   

Mission:  To improve the health of people we touch.
Vision:  To be recognized locally, regionally and nationally as a premier health system.

R.E.S.P.E.C.T.:  We will fulfill the mission and vision by adhering to the Standards of R.E.S.P.E.C.T.
 Responsiveness
 Enthusiasm
 Safety
 Privacy
 Excellence
 Communication
 Teamwork

Job Details

Date Posted August 11, 2017
Date Closes November 9, 2017
Requisition 18518
Located In Chattanooga, TN
SOC Category 00-0000.00
Location