Revenue and Billing Compliance Coordinator

Job not on LinkedIn

🔥 0 minutes ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

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ThedaCare

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

ThedaCare is a non-profit healthcare organization that has been serving the communities of Northeast and Central Wisconsin for over a century. ThedaCare operates seven hospitals and 35 clinics, providing access to a wide range of medical services including cancer treatment, orthopedic care, trauma services, and cardiovascular programs. With a commitment to delivering high-quality healthcare, ThedaCare serves more than 235,000 patients annually and collaborates with Mayo Clinic specialists to enhance patient care.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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