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Care New England · 5 months ago

Revenue Cycle Coverage Specialist

Warwick, RI

Full-time

Onsite

Entry Level

1+ years exp

Care New England is a trusted organization in the healthcare sector, focusing on medical research and innovative programs. The Revenue Cycle Coverage Specialist plays a vital role in ensuring the efficiency of claims and billing processes, addressing issues related to claim edits and insurance discrepancies to support optimal reimbursement.

AssociationHealth Care

H1B Sponsor Likely

Responsibilities

Accurately capture and update billing information to ensure timely and seamless claim submission

Proactively identify and resolve claim edits, charge review errors, and billing issues tied to registration or insurance discrepancies

Confirm insurance eligibility and coverage details to avoid delays in claim processing

Investigate and correct denials caused by inaccurate or incomplete payor information

Monitor trends in claim edits and denials, and share insights to drive continuous improvement

Work collaboratively with payors, patients, and internal teams to gather missing information and expedite claim resolution

Maintain thorough documentation and stay compliant with all timely filing requirements and regulatory standards

Flag critical billing or insurance issues to leadership and contribute actionable solutions for process enhancements

Support team success by pitching in where needed, fostering collaboration, and protecting patient confidentiality

Take on additional tasks as needed to keep the revenue cycle running smoothly

Manage priorities effectively, staying flexible and responsive to shifting workflows and department needs

Consistently meet deadlines and performance expectations through organized, focused work habits

Offer suggestions to improve systems, services, and tools that enhance overall efficiency

Apply sound judgment when making decisions, relying on knowledge of policies and best practices

Build strong relationships with both internal and external customers through proactive and attentive service

Recognize the impact of customer interactions on organizational goals and uphold high service standards

Follow established protocols and leverage available tools to deliver dependable support

Communicate openly and effectively across departments and organizational levels

Qualification

Claim resolutionInsurance verificationBilling processesCustomer serviceProblem-solvingAttention to detailDocumentation skillsCommunication skills

Required

Must possess a high school diploma or equivalent

Minimum of 1-3 years of previous customer service experience in a healthcare or business environment required

Company

Care New England

Care New England (CNE) is a non-profit health system, comprising several hospitals in Rhode Island, including Butler, Women & Infants

Founded in 1996

Providence, Rhode Island, USA

5001-10000 employees

http://www.carenewengland.org

H1B Sponsorship

Care New England has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2024 (3)

2023 (2)