• Monday - Thursday 8:00am -4:30pm, Friday 8:00am -3:00pm

• Reviews, analyzes and resolves patient (or representative) concerns of an escalated nature. Ensures complete and consistent resolution on all concerns. Research validity of the compliant by reviewing supporting clinical and financial documentation.
• Communicates the resolution effectively to patient (or representative) in a reasonable timeframe (as established by performance standards) and escalates unresolved matters to management.
• Manages escalated calls from Customer Service or internal departments while adhering to HIPAA regulations.
• Manages escalated correspondence via email or mail from Customer Service or internal departments by accurately documenting the receipt and communicating the receipt and resolution timeframe to the sender.
• Communicates in a professional and courteous manner with customers while maintaining call productivity standards as determined by the department. Exudes a high level of patience, understanding and compassion in all communications with customers.
• Performs financial reviews on patient accounts such as charge auditing, billing reviews, estimate, and estimate audits and other financial transaction validation. Evaluates financial transactions with an independent perspective to ensure accurate outcomes.  

• Three years of experience in Patient Access, Patient Financial Services or Revenue Integrity
• Experience in handling escalated complaint calls (Preferred)
• Understanding of CCI edits, CPT, HCPCS, ICD CM/PCS, and Revenue Codes (Preferred)
• Knowledge of Registration, HIM Coding, Government, and Managed Care billing rules, coverage, payment, and compliance (Preferred)

The Resolution Coordinator, under general and direct supervision by manager, is part of a central team responsible for escalated patient concerns for Revenue Cycle Financial Operations departments to include Patient Access, Patient Financial Services and Revenue Integrity. Reviews concern with an unbiased perspective by researching and auditing any financial elements such as charges, insurance billing, and other financial transactions. Works with internal and external departments to complete research and assist with resolution and ensures consistent resolution procedures with all concerns and communicates resolution with patient (or representative).

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About AdventHealth

At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.

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