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Covenant Health APPLICATION COORDINATOR - HOSPITAL BILLING/CLAIMS (Bangor, Maine) in Bangor, Maine

JOB SUMMARY

The Application Coordinator (AC) - Billing, working as a member of the Information Systems (IS) team, participates in the development and design of the application(s) for which the incumbent is responsible and is required to gain an in-depth knowledge of the application(s). The AC will be knowledgeable about organizational policies and procedures, workflows, business operations for the area of business they are representing, and the functionality available in the application(s). The AC will communicate with the Good Help installation team, review the software, analyze business operations, work with Good Help and end users to tailor the system to the organization, and often participate in the initial training of end users. The incumbent will participate in current state mapping and future state workflow development, application design and development, testing, issue resolution, application integration, implementation and ongoing support activities. The AC will perform in-depth analyses of workflows, data collection, report details, and other technical issues associated with the use of Good Help software. The AC will be responsible for developing and documenting the internal procedures that will be used in conjunction with vendor applications and will assess implementation strategies and the impact those strategies will have on workflows and operations. The incumbent will actively participate in all relevant Enterprise and local system Design, Build, Validate (DBV) sessions.

Essential Duties and Responsibilities

A representative summary of tasks to be performed by the incumbent is provided below. The incumbent may be asked to perform job-related tasks other than those specifically stated in this description. The duties and responsibilities of the position are to be carried out in a manner that is consistent with the mission, values and operating principles of Covenant, and in-line with the organization's Code of Conduct. The AC serves on the team that designs, builds, and validates the processes for their respective application(s). In addition to the duties discussed above, the incumbent is responsible for the following:

  • Knowledgeable of all aspects of the operational areas of the business office, including billing, insurance verification, transaction posting, contractual allowance processing, UB coding and bill creation, collection activities related business office processes

  • Assessing implementation strategies and the impact those strategies will have on workflows and operations

  • Working closely with Good Help Connections support on issues of install choices, master file and category list set up, synonyms and preference lists, etc.

  • Assisting in building new data sets and testing of new functionality

  • Documenting current and new workflows

  • Working with the appropriate subject matter experts in the Design, Build, Validate (DBV) sessions

  • Understanding how workflow decisions translate to application configurations

  • Developing and documenting internal procedures that will be used in conjunction with the business office applications

  • Achieving in-depth knowledge of the software and serve as a bridge between end users and vendor implementation staff

  • Participating in regular day-to-day communication with Good Help’s installation team, reviewing the software, analyzing business operations, and working with the vendor and end users to tailor the system to the organization

  • Performing in-depth analyses of workflows, data collection, report details, and other technical issues associated with the use of the software

  • Troubleshooting problems or questions from users

  • Prioritizing and implementing changes requested for the system

  • Coordinating software updates and changes with users

  • Working with users on the sharing of data, category lists, etc.

  • Reviewing new vendor software releases and updates to help determine which features will be utilized

  • Frequently provides status reports to the management

  • Investigating the preferred choice of the users

  • Analyzing data conversion needs

  • Preparing details of specifications as needed

  • Development and preparation of test scenarios

  • Participates in testing activities

  • Aiding trainers during user training

  • Assists in developing risk mitigation strategies

  • Collecting information regarding potential system enhancement needs

  • Responding to vendor's technical questions

  • Maintaining rules for how each new version is released

  • Analyzing new functionality in new releases to determine whether or how it should be used

  • Other duties as assigned

EDUCATION AND EXPERIENCE

The incumbent must be flexible, highly collaborative and consistently work to fill gaps and avoid overlaps in local system activities. A key requirement for the incumbent is to continuously listen, react and suggest ways to complement or assist the work of others. The ideal manifestation of the role is when all involved parties seek out the incumbent as an expert resource and thought partner, which will ensure that the work is fluid and relevant to current issues.

Required Qualifications

  • Bachelor's degree from an accredited university or college in the Business Sciences, Health Sciences (Nursing, Medicine, etc.) or in Information Systems. Candidates who do not meet this requirement may be considered if they have achieved applicable certifications and requisite work experience

  • Clinical or operational experience in the area related to the business office application

  • Hospital Claims billing experience

  • Demonstrated proficiency with information systems technology

  • Superior goal accomplishment skills

  • Demonstrated knowledge of revenue cycle management

  • Ability to facilitate the engagement of end users in the Design, Build, Validate Sessions

  • Demonstrated workflow process analysis and design

  • Demonstrated facilitation/training skills

  • Strong assertiveness skills, ability to manage conflict in a variety of situations

  • Effective leadership skills and strong customer service orientation

  • Superior organizational and people management skills

  • Strong communication and interpersonal skills

  • Demonstrated ability to align and motivate key process stakeholders, including patients, staff, scheduling staff, registration staff, unit clerks, nurses, physicians, and other clinical/administrative staff

  • Demonstrated ability to interact with multidisciplinary teams

  • Achievement of Good Help Application Credentialing

  • Proficient with Microsoft Office Suite, email, intranet, internet, and other systems

Preferred Qualifications

  • Experience with implementing clinical information systems and/or large-scale and complex standardization and implementation of an EMR is highly desirable

  • Demonstrated application design and implementation skills

  • Knowledge and/or experience in the coordination claims and remittance activities, including submitting and processing paper and electronic claims

  • Demonstrated knowledge of inpatient, outpatient, and ancillary billing functions and activities

  • Demonstrated knowledge or experience with the following concepts: account receivables, billing, paperless collections/follow up, transaction editing, payor management, electronic data interchange, payment posting, refunds, collection worklisting, fee schedules, deductibles, bad debt, write offs, payors, financial service codes, coding/charge capture, charge review, claims/claims editing, payment posting, customer service/credit & collections, insurance follow up, and coordination of benefits

  • Demonstrated experience in using IT applications to improve revenue cycle results, including cash collections, days in A/R, bad debt and denial reductions

Working Conditions/Physical Demands

Travel is required, on a regular basis, to Covenant Systems, as well as to Good Help Connections meetings.

This is an exempt position requiring hours of work that extend beyond the traditional work hours, including evenings and weekends.

Americans with Disabilities Statement

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

Covenant Health Mission Statement

We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities.

Core Values

Compassion

We show respect, caring and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable and suffering.

Integrity

We promote justice and ethical behavior, and responsibly steward our human, financial and environmental resources.

Collaboration

We work in partnership, dialogue and shared purpose to create healthy communities.

Excellence

We deliver all services with the highest level of quality, while seeking creative innovation.

We are an equal opportunity, affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sexual orientation, ancestry, protected veteran status, national origin, genetic information or any other legally protected status.

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