Serve as a key member of the Revenue Cycle Management team and contribute to the overall performance and health of the Company's accounts receivable (AR). The Senior Insurance and Pricing Coordinator takes on additional leadership within the Revenue Cycle Management department to assist Management with project based and IT related initiatives, as well as fulfill the primary duties of the role. The primary objective of this position is to maintain and preserve the integrity of the company pricing and insurance master.
- Maintain the Decision Matrix base data, and interface with IT on enhancement rollouts as needed.
- Oversee the maintenance of the insurance payer pricing file for the organization. Ensure the review, process, and loading of new contracts or pricing and changes to current contracts/pricing are completed timely.
- Evaluate payment trends to determine if AHOM reimbursement and/or pricing files are accurate.
- Communicate discrepancies and work with payers to reconcile differences.
- Oversee the maintenance of the insurance payer master file for the organization. Ensure the review, processing, and loading of new payers and changes to existing payer attributes are completed timely.
- Work collectively with Billing Centers & Sleep Support Center Management to determine root cause on denials related to insurance master attributes and update as necessary.
- Work cross-functionally with billing centers, branches, sleep support centers and patient service centers to complete pricing and master file clean up. Take ownership of the databases to ensure the highest level of data integrity.
- With Accounts Receivable Manager, develop IT requirements and AHOM business rules to implement or improve processes, increase productivity through automation, and provide front end user support and/or testing of new applications as needed.
- Maintain availability for urgent requests from billing centers, branches, sleep support centers and patient service centers to complete payer or pricing updates on demand as needed by the business.
- Demonstrate leadership to others within the team, the department, and the organization.
- Report weekly to Management on progress of work plan action items and communicate reasons for slippage in the timelines.
- Bachelor degree or equivalent years in work experience.
- 4+ years of healthcare experience with specific expertise in revenue cycle operations
- Demonstrated success working independently and managing changing priorities for multiple simultaneous tasks.
- Demonstrated success working on cross-functional projects
- Demonstrated ability to interface with all departments in the organization, as well as outside vendors.
- Demonstrated ability to respond timely to data requests and meet strict deadlines.
- Strong Microsoft Office (Word, Excel, Outlook) skills.
- Experience with multi-site billing and collections operations a plus.
- Demonstrated understanding of the regulatory trends and strategies associated with Medicare, Medicaid, Commercial and Private Pay insurance reimbursement
American HomePatient is an equal opportunity, access and affirmative action employer. All qualified applicants will receive consideration for employment regardless of race, color, religion, creed, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. American HomePatient provides reasonable accommodations for qualified individuals with disabilities. Because American HomePatient believes in providing a safe work environment, we conduct drug and background checks in our recruiting/hiring processes. AA/EOE, M/F/Disabled/Veterans