Revenue Operations Coordinator

Revenue Operations Coordinator (Credentialing) The Revenue Operations Coordinator provides oversight and operational support across the full Revenue Cycle Management (RCM) process, from insurance verification through claim payment, while working on back-end credentialing and contracting. This role will work closely with providers, insurance companies, credentialing organizations, and internal departments to ensure accurate insurance benefit contracting, verification, and timely provider credentialing. The successful candidate will demonstrate a high level of professionalism, strong organizational skills, and a thorough understanding of insurance verification, payer enrollment, and credentialing processes. Job Duties and Responsibilities: Verify insurance benefits and eligibility for prospective and current clients Contact insurance providers to obtain detailed coverage information, including deductibles, copays, coinsurance, out-of-pocket maximums, and authorization requirements Document and communicate benefit information accurately to admissions, clinical, and billing teams Maintain accurate records of all verification activities and insurance communications Prepare, submit, and monitor provider for credentialing and recredentialing applications with commercial insurance plans, Medicaid, and other payers. Maintain provider credentialing files, licenses, certifications, malpractice insurance, and CAQH profiles to ensure ongoing compliance. Assist with obtaining and tracking pre-authorizations and concurrent reviews as needed Identify and communicate potential coverage limitations, exclusions, or financial responsibilities Collaborate with admissions, billing, and utilization review teams to support timely admissions and continuity of care Follow up with insurance companies regarding incomplete, pending, or conflicting benefit information Escalate complex insurance, authorization, reimbursement, or coverage concerns to appropriate leadership or revenue cycle personnel. Ensure compliance with HIPAA regulations, organizational policies, and applicable regulatory requirements Perform all other duties as assigned Qualifications Strong understanding of commercial insurance, managed care, and behavioral health benefits Knowledge of behavioral health levels of care, including residential, partial hospitalization, intensive outpatient, and outpatient services preferred Excellent attention to detail and accuracy in documentation Strong verbal and written communication skills Ability to multi-task and prioritize workload and meet deadlines in a fast-paced environment. Strong analytical and problem-solving abilities Effective time management and organizational skills Ability to work independently and collaboratively within a team environment Knowledge of insurance authorization processes and payer requirements Minimum Qualifications: High school diploma or equivalent required. Minimum one (1) year of behavioral health insurance verification, credentialing, billing, revenue cycle, or related experience preferred. Ability to process a high volume of work while maintaining accuracy and attention to detail. Proficient in electronic health records (EHR), insurance verification platforms, and standard business software. Familiarity with HIPAA regulations and healthcare compliance standards. #J-18808-Ljbffr Priority Dispatch Corp.