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FERC Coordinator

Company: Rochester General Health System
Location: Rochester
Posted on: November 19, 2021

Job Description:

* Position Summary: The FERC Coord works in collaboration with manager and a group of individuals to ensure accuracy of charges for multiple departments. Reviews multiple work queues daily for edits, missing charges, insurance and prior authorizations. Ensures timely submission of claims. Reviews reconciliation reports to ensure charges are captured for all patients and all services rendered. Reports trends to manager and identifies when additional training is needed for staff. The FERC coordinator is a subject matter expert in all front end workflows and is able to perform these roles in a professional and knowledgeable manner. Key Responsibilities: * Review/resolves charge review work queues for assigned sites for completeness and accuracy * Reviews/resolves claim edit work queues completeness and accuracy * Works with sites to obtain additional information from providers and/or patients * Verification of insurance eligibility/coverage * Communicates professionally and timely with both internal and external customers such as but not limited to; payers, physician offices and other departments. * Works closely with billing department on insurance denials and trends * Reviews charge reconciliation reports for missing charges and correct billing of split charges; understands PB and HB charges, PBB payors, traditional PBB, non-traditional PBB. * Reviews follow up WQ for denials and monitors for trends by insurance and/or department; responds to billers' questions in a timely manner. * Reviews denial reports with leadership team. * Handles patient billing questions, doing appropriate research. * Runs revenue cycle reports as needed by practice. * Monitors point of service payment collections; identifies opportunities where they exist and works with team members to improve collection rates. * Centralized support team will perform follow-up on initial denials, including resubmission of claims when necessary, or escalation to CBO when charge is corrected. * Support team located at the practices will work closely with clinical team to ensure all charges are captured. * Performs other duties as assigned Revenue Cycle Verification Team: * Confirms the need for an authorization and takes the appropriate actions to ensure the authorization is obtained * Verifies the basic patient/service information is available - the minimum data set for the admission. If not present, initiates appropriate activity to obtain the required data set, such as admission diagnosis. * Prioritizes the urgency of the authorization by anticipating the approximate time it may take to obtain the authorization from the insurance company; follows up with insurance company to accelerate responses and expedite urgent/emergent authorizations. * Understands the critical delineations of patient status (inpatient vs observation) based on payor specific regulations and guidelines * Advises and coordinates with providers (Utilization Management Team) regarding problematic (i.e. high risk) admissions or any episode of service requiring additional attention Desired Attributes Basic computer skills highly desired. Excellent customer service and communication skills highly desired." Minimum Qualifications: Five years related work experience in a healthcare setting preferred. Required Licensure/Certification Skills: * None Rochester General Health System is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran * Job Description Job Description * Review/resolves charge review work queues for assigned sites for completeness and accuracy * Reviews/resolves claim edit work queues completeness and accuracy * Works with sites to obtain additional information from providers and/or patients * Verification of insurance eligibility/coverage * Communication with external customers such as but not limited to; payers, physician offices and other departments. * Works closely with billing department on insurance denials and trends * Reviews charge reconciliation reports for missing charges and correct billing of split charges; understands PB and HB charges, PBB payors, traditional PBB, non-traditional PBB. * Reviews follow up WQ for denials and monitors for trends by insurance and/or department; responds to billers' questions in a timely manner. * Reviews denial reports with leadership team. * Handles patient billing questions, doing appropriate research. * Runs revenue cycle reports as needed by practice. * Monitors point of service payment collections; identifies opportunities where they exist and works with team members to improve collection rates. * Centralized support team will perform follow-up on initial denials, including resubmission of claims when necessary, or escalation to CBO when charge is corrected. * Support team located at the practices will work closely with clinical team to ensure all charges are captured. * Performs other duties as assigned * Additional Job Description Additional Job Description Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations. * Job Title Default Job Title Default FERC Coordinator * Restrict to Country Restrict to Country (empty) * Management Level Management Level * Team Member * * Job Level Job Level * Base 15 Accrued * * Job Family Job Family * Admin/Business Support * * Job Category Job Category * Administrative/Business Office * * Job Classifications Job Classifications * 15 - Administrative Support Workers (EEO-1 Category-United States of America) * * 7245 - Reg Earnings - General Support Staff (DEPRECATE) (G/L Sub-Account (DEPRECATE)-United States of America) * * J - Non Licensed (Shift Rate Status Flag-United States of America) * * Non-Exempt - (FLSA Category-United States of America) * * NONNONCLINC - Non-Exempt Non-Clinical Job (DEPRECATE) (Grade Range Schedule (DEPRECATE)-United States of America) * More (2) * Work Shift Required Work Shift Required No * Public Job Public Job Yes * Referral Payment Plan Referral Payment Plan (empty)

Keywords: Rochester General Health System, Rochester , FERC Coordinator, Other , Rochester, New York

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