Revenue and Billing Compliance Coordinator

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🕒 Agosto 27

🧀 Wisconsin – Remoto

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⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🚔 Conformidade

🦅 Patrocina Visto H1B

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👻 Score fantasma 22%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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ThedaCare

5001 - 10000 funcionários

💼 Consultoria

🛡️ Seguros

🏥 Saúde

Consulting • Insurance • Healthcare

Por mais de um século, a ThedaCare está comprometida em encontrar uma maneira melhor de oferecer cuidados de saúde sérios e complexos para pacientes em todo o nordeste de Wisconsin. A organização atende mais de 235.000 pacientes anualmente e emprega mais de 7.000 profissionais de saúde em toda a região. A ThedaCare possui sete hospitais localizados em Appleton, Neenah, Berlin, Waupaca, Shawano, New London e Wild Rose, além de 35 clínicas em nove condados. A ThedaCare é a primeira em Wisconsin a ser membro da Rede de Cuidados da Mayo Clinic, permitindo que nossos especialistas consultem os especialistas da Mayo Clinic sobre o cuidado de um paciente. A ThedaCare é uma organização de saúde sem fins lucrativos com um centro de trauma de nível II, tratamento abrangente de câncer, programas de AVC e cardíacos, além de uma fundação dedicada ao serviço comunitário.

Descrição

• Partner with clinical, revenue cycle, compliance, and finance departments to monitor, communicate, and implement compliant billing practices • Serve as subject matter expert on regulatory and payer policies • Implement regulatory and payer policy changes • Investigate billing requirements supporting new clinical services • Research and provide billing guidance for new services and charge codes • Identify opportunities for accurate and comprehensive charge capture • Support departments with payer and regulatory policy implementation • Monitor telehealth billing and reimbursement • Audit professional claim accuracy with compliance and revenue cycle teams • Monitor and resolve charge router errors • Maintain charge reconciliation with clinical leaders • Monitor Revenue Cycle AI solutions for compliance and accuracy • Research policies to support appeals for global denial trends • Manage payer denial trends and ensure timely resolution or escalation • Resolve government payer audits and communicate volumes and escalations • Administer payer portals • Perform other duties as assigned

🎯 Requisitos

• Minimum 5 years of progressive experience in revenue cycle or healthcare compliance • 3 years of experience specific to physician billing and coding • Nationally recognized physician coding certification • Strong understanding of billing, coding, regulatory, and payor policies, including telehealth billing requirements across commercial and government payers • Exceptional communication, presentation, and interpersonal skills • Excellent investigational skills • Ability to work independently • Strong Excel and PowerPoint skills • Excellent time management and ability to prioritize in a fast-paced, growth environment • Knowledge of healthcare regulations and compliance requirements • Experience with Epic practice management system • Bachelor’s degree in HIM, Healthcare Administration, Business, Finance, or a related field preferred

🏖️ Benefícios

• Lifestyle Engagement, including health coaches, relaxation rooms, health-focused apps (Wonder, Ripple), and mental health support • Access & Affordability, including minimal or zero copays, team member cost-sharing premiums, and daycare • Continued opportunities for learning and development • Accessible and transparent leadership • Commitment to work/life balance • Flexible schedule

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