Revenue Cycle Coverage Validation Representative

Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope's growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today.

As a successful candidate, you will:

• Be responsible for daily management of registration and insurance related errors in the following EMR modules: Charge Review, Claim Edit, Follow Up, Retro Review, Remittance
• Be responsible for registration and coverage validation for all new COH patients received via manual charge capture process.
• Re-verify insurance information and/or coordination of benefits, to confirm eligibility and coverage via payors website or phone call.
• Notify other pertinent COH staff regarding health care coverage changes for billing correction purposes, while maintaining a positive and collaborative manner interactions with colleagues and others.
• Respond timely and accurately to all incoming correspondence from payors, patients, and other COH departments.
• Report trends related to system and/or workflow issues to management team, to identify root cause and resolution.
• Initiate recommendations and act, when appropriate, in resolving complex patient account issues related to coverage/eligibility.
• Collaborate with Revenue Cycle Collectors for submission of corrected claims, and/or communicates with Refund Clerks for payment recoupment, and/or completes Registration for manual charge entry.
• Work independently and organize and prioritize workload with limited to no supervision.

Candidates who meet the requirements and have background in the areas below are encouraged to apply;

Insurance, Verifier, verification, Insurance Verifier, financial clearance, Financial Counselors, Unit Secretary, Admitting Rep, registration, intake, admissions.

Your qualifications should include:

• High school diploma
• Two or more years of experience in a hospital, medical group or Independent Practice Association (IPA).
• Thorough knowledge of HMO, PPO, POS coverage rules.
• Medical terminology and EMR experience. Epic experience preferred.
• Knowledge of medical EOBs/ERAs/HCFA preferred

Additional Information:

City of Hope employees pay is based on the following criteria: work experience, qualifications, and work location.

City of Hope is an equal opportunity employer. To learn more about our commitment to diversity, equity and inclusion, please click here.

To learn more about our Comprehensive Benefits, pleaseCLICK HERE