Revenue Cycle Representative

Key Responsibilities:

• Completes insurance verifications and identifies terming approvals
• Monitors and tracks documentation, authorization renewals and benefits exhaustion
• Ensures the Common Working File is properly updated with services provided
• Reviews, corrects and updates claims based on edits to support accurate and compliant claims submissions
• Completes claim follow-up, denials, appeals and corrections
• Completes medical records requests by payers
• Completes daily, weekly and monthly reporting as assigned my leadership to ensure proper and compliant claims processing
• Pursues collections of unpaid self-pay/private pay balances
• Processes and submit monthly patient statements
• Perform self-pay/private-pay collections calls, send collections letters on past due accounts
• Collaborates with clinical staff to resolve complex billing issues
• Completes payment posting, correct posting errors, research credits and reconcile posting errors
• Provides support to the clinical team regarding payer questions, tools and resources, assisting with problem solving as needed

Required Qualifications:

• 2+ years of experience in healthcare billing, pre-services, accounting or financial analysis

Preferred Qualifications:

• Associate or bachelor’s degree in healthcare administration, finance, business administration, accounting or a related field preferred or commensurate professional experience
• 2+ years of healthcare revenue cycle experience