Revenue Cycle Coordinator III

Job Summary:

The Revenue Cycle Coordinator III is responsible for providing oversight in the research and resolution of member related eligibility and billing complaints from internal customers and governing entities.

Essential Functions:

• Utilize key accounts receivable and reporting experience and knowledge to ensure timely and accurate recording and reporting of accounts receivable activity
• Provide support to Revenue Cycle Specialists in the research and resolution of member complaints
• Serve as a subject matter expert (SME) for eligibility and billing processes and procedures
• Ensure full resolution of consumer complaint cases submitted by governing entities within regulatory timeframes and defined requirements
• Complete and thoroughly document all issues
• Identify irregular trends; work with other areas as appropriate to identify root causes and take appropriate steps for resolution
• Develop and maintain an in-depth knowledge of the company’s business and regulatory environments
• Make appropriate changes to ensure compliance with MAR, regulatory and other organization requirements
• Collaborate with management to correct deficiencies in SLA and quality
• Participate in ongoing development of new products and technologies
• Responsible for the development of training for new products and technologies
• Develop and teach others using standard operating procedures and training tools
• Participate in Readiness Reviews and desk audits with State and Federal partners
• Assist with the completion of required reporting
• Ensure all HIPAA and State requirements/regulations are adhered to at all times
• Ad-hoc and free interchange with all departments, managers and director level personnel
• Perform any other job duties as requested

Education and Experience:

• Associate Degree in business, finance or related field or equivalent years of relevant work experience is required
• Bachelor's Degree is preferred
• Minimum  of four (4) years of experience in billing, customer service or claims is required
• Minimum of one (1) year experience in Revenue Cycle Operations required
• Managed care or healthcare experience is preferred
• Enrollment, billing, finance or data analysis experience is preferred

Competencies, Knowledge and Skills:

• Strong interpersonal skills
• Ability to lead and direct the work of others
• Customer service oriented
• Demonstrates decision making and analytical/problem solving skills to perform a variety of complicated tasks.
• Attention to detail
• Possesses critical thinking/listening skills
• Ability to write comprehensive statements using proper grammar and sentence structure
• Intermediate proficiency in Microsoft Office Suite to include Word, Excel and PowerPoint
• Training/teaching skills
• Ability to work with others and independently
• Wide degree of creativity and latitude (independent judgment) is required
• Relies on extensive experience and judgment to plan and accomplish goals. 
• Excellent written and verbal communication skills
• Ability to develop, prioritize and accomplish goals
• Public speaking skills
• Ability to work in a fast-paced and constantly changing environment

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business