Revenue Cycle Coverage Validation Rep

Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today.

As a Revenue Cycle Coverage Validation Representative, you will play a critical role in ensuring accurate patient registration, insurance verification, and coverage validation. This position supports the revenue cycle by resolving insurance‑related errors, validating eligibility, and collaborating closely with internal teams to support correct billing and timely reimbursement. You will work independently while contributing to a collaborative, mission‑driven environment dedicated to patient‑centered care.

As a successful candidate, you will:

• Manage registration and insurance‑related errors across multiple EMR modules, including Charge Review, Claim Edit, Follow Up, Retro Review, and Remittance
• Perform registration and insurance coverage validation for new City of Hope patients through manual charge capture processes
• Re‑verify insurance information and coordination of benefits as requested by internal departments via payer websites or phone calls
• Communicate healthcare coverage changes to appropriate internal teams to support accurate billing corrections
• Respond promptly and accurately to correspondence from payors, patients, and City of Hope departments
• Identify and report system or workflow trends to leadership to support root‑cause analysis and process improvement
• Resolve complex patient account issues related to eligibility and coverage with sound judgment and initiative
• Collaborate with Revenue Cycle Collectors, Refund Clerks, and Registration staff to ensure claims accuracy and payment resolution

Your qualifications should include:

• High school diploma required
• Two (2) to five (5) years of experience in a hospital, medical group, or Independent Practice Association (IPA)
• Strong knowledge of HMO, PPO, and POS insurance coverage rules
• Experience with medical terminology, EMRs, and revenue cycle billing workflows
• Familiarity with medical EOBs, ERAs, and HCFA forms preferred
• Experience using payer portals such as Noridian, Medi‑Cal, Availity, Blue Shield, Passport, and others
• Proficiency in electronic health records systems (Epic preferred), word processing, and spreadsheets
• Excellent written, verbal, and interpersonal communication skills
• Ability to manage priorities independently while maintaining accuracy and confidentiality

City of Hope employees’ pay is based on the following criteria: work experience, qualifications, and work location.

City of Hope is an equal opportunity employer.