The Revenue Cycle Complaints Coordinator specializes in patient complaint management and de-escalation. This role is responsible for addressing and resolving complex patient concerns related to billing, insurance, and account inquiries. The specialist works closely with internal teams to investigate issues, ensure timely resolution, and uphold compliance with regulatory and organizational standards.
Additional Information
Department Name: Patient Financial Services
Job Status: Full time, 40 hours per week.
Shift: Monday to Friday. 8am to 4:30pm, hybrid
Duties & Responsibilities
POPULATION SPECIFIC CARE
No direct patient care.
ESSENTIAL FUNCTIONS
An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all of the functions which the employee may be expected to perform.
1. Perform the role as the central contact for all Revenue Cycle complaints, ensuring prompt, accurate, and empathetic resolution.
2. Collaborate with patients and families to resolve Patient Responsibility (PR) balances related to non-covered services, including direct outreach to insurance providers to explore overturning balances when appropriate.
3. Support guarantors with drafting and submitting insurance appeals, providing step-by-step guidance throughout the process.
4. Act as a liaison between Patient Relations and internal Revenue Cycle teams to ensure alignment and efficiency in addressing concerns.
5. Identify trends, barriers, and opportunities for process improvement within the Revenue Cycle and patient financial experience.
6. Maintain compliance with hospital policies, state/federal regulations, and payer requirements.
7. Provide clear documentation and tracking of complaints and resolutions in appropriate systems.
8. Bring forward opportunities and/or solutions to make improvements internally where needed based on findings through complaint resolution process.
Guidelines: Developmental, standard, or intermediate level. Guidelines are generally numerous, well established, and directly applicable to the work assignment. Work assignment and desired results are explained by general oral or written instructions.
Complexity: Falls between the entry and full performance/senior level. Duties assigned are generally repetitive and restricted in scope but may be of substantial intricacy. Employee primarily applies standardized practices.
Decision Making: Decisions or recommendations on non-standardized situations are limited to relating organizational policies to specific cases. Brings non routine issues to supervisor. Problems that are not covered by guidelines or that are without precedent are taken up with the supervisor.
Communications: Contacts with team members, clients or the public where explanatory or interpretive information is exchanged, gathered, or presented and some degree of discretion and judgment are required within the parameters of the job function.
Supervision Received: Under normal supervision, within a standardized work situation, the employee performs duties common to the line of work without close supervision or detailed instruction. Work product is subject to continual review.
Minimum Qualifications
- Degrees
- Experience
- Three (3) years of healthcare and/or revenue cycle experience.
- Equivalency
Salary Information
Pay is dependent on applicant's relevant experience.
Hourly Range: $22.20 to $33.30
Benefits Information
Here, you matter. As a Children's Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.
As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.
Children's Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.
EEO Statement
It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information. The position is expected to stay open until the posted close date. Please submit your application as soon as possible as the posting is subject to close at any time once a sufficient pool of qualified applicants is obtained.
Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of attendance at or graduation from an educational institution. You will not be penalized for redacting or removing this information.