Job Description
Responsibilities
Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two.
Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members.
Founded in 3, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc.
UHS) in 4. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships.
Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.
Learn more at :
Job Summary : The Revenue Project Coordinator - COB will focus on Medicare Secondary Payer (MSP) claims, Coordination of Benefits (COB) claims, and medical coverage overlaps with other insurance carriers to ensure accuracy of claims payments.
Investigate and analyze Medicare Secondary Payer demands for coordination of benefits with Medicare. Reviews cases to determine primary liability when not established.
Maintains system information regarding coverage overlaps and primacy to ensure correct coordination occurs with Medicare.
Research claims history to identify previously paid claims for recovery.
Benefit Highlights :
- Loan Forgiveness Program
- Challenging and rewarding work environment
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
K) with company match and discounted stock plan
- SoFi Student Loan Refinancing Program
- Career development opportunities within UHS and its + Subsidiaries! · More information is available on our Benefits Guest Website : benefits.uhsguest.com
About Universal Health Services :
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc.
UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune;
and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.
S. States, Washington, D.C., Puerto Rico and the United Kingdom.
Qualifications
Qualifications and Requirements :
- High School diploma; Bachelor’s degree preferred
- 2-4 years of related experience in COB / TPL or other healthcare related field
- Advanced SQL skills to aid in identification of cases to be worked
- Knowledge in working with third party payers
- Knowledge of the MSP process
- Program and Project Management skillset
- Capable interpersonal skills to easily establish rapport with provider office staff
- Self-starter with an ability to work autonomously, managing own workload to drive results
- Highly organized with attention to detail
- Demonstrated ability to follow through on project work
- Able to learn key concepts and processes quickly
- Microsoft Office proficient (Excel, Word, Outlook) and / or Smartsheet
- Resourceful with ability to find and optimize additional revenue
- Performs other duties as assigned or required