Sorry, this job is no longer accepting applications. See below for more jobs that match what you’re looking for!

Revenue Cycle Representative III

Expired Job

Piedmont Healthcare Atlanta , GA 30301

Posted 3 months ago

RESPONSIBLE FOR:

The Revenue Cycle Representative III (Rep III) is a multi-tasking advanced position that encompasses all key functions of the physician billing Revenue Cycle. The Rep III position requires an advanced revenue cycle knowledge that has been acquired through experience and developed through training and education.

The Rep III supports patient-centered care and Customer Service by serving as a patient advocate during the life cycle of the account. The Rep III is expected to maintain productivity above the average standard identified by the Revenue Cycle Department. Quality and accuracy of work performed by the Rep III is expected to be consistently above 90% when audited. Rep III performance will be measured according to the Piedmont Healthcare values of Compassion, Commitment, Service, Excellence and Balance and expected to be tiered in the top 1/3 in the department.

Rep III Revenue Cycle duties may include but are not limited to Core Functions: Billing, Claims Filing, Data Entry, Charge Entry, Insurance Follow-Up, Self-Pay Follow-Up, Denial Management, Payment Posting, Refund Management, Credit Balance Management, Account Correction and Adjustment, Response to Patient Account Inquiries, Customer Service Advocacy, Self-Pay Collections, and Unapplied Cash, as well as, Advanced Functions; File Maintenance, System Support, Claims Edit Management, Claims Rejection Management, Front End Management, and Payment Variance Management.

The Rep III Employee will be proficient in one or more advanced Revenue Cycle responsibilities or functions. Advanced Revenue Cycle responsibilities and functions are those above and beyond that of Core Revenue Cycle functions

MINIMUM EDUCATION REQUIRED:

High School graduate or GED.

MINIMUM EXPERIENCE REQUIRED:

Requires a minimum of 5(five) years of experience exhibiting advanced performance in a physician billing revenue cycle or Central Business Office.

MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:

None

ADDITIONAL QUALIFICATIONS:

Advanced knowledge of third-party insurance in regards to plan types: HMO, PPO, POS, and Indemnity.

Excellent knowledge of the Medicare Program particularly as it relates to CPT and ICD9 coding CPT. Thorough knowledge of Medicare Fraud and Abuse regulations. Ability to counsel patients financially regarding outstanding charges and effectively resolve problems via the highest customer service skills and etiquette.

Possesses advanced knowledge of the Practice Management System. Possesses the ability to run standard reports in order to answer questions from practice manager and physicians. Possess thorough knowledge of HIPAA regulations. This job requires proficiency with the computer systems that are used in the practice including Practice Management System, Internet products that relate to office functions and Microsoft office systems available to the office.



See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Revenue Cycle Specialist II

Emory Healthcare

Posted 5 days ago

VIEW JOBS 12/6/2018 12:00:00 AM 2019-03-06T00:00 DescriptionJOB DESCRIPTION: Responsible for Emory Hospitals, including Emory University Hospital, Emory University Hospital Midtown, Emory Saint Joseph Hospital, Emory Johns Creek Hospital, Wesley Woods Hospital, Emory University Orthopedics and Spine Hospital, Emory Smyrna Hospital, A Rehab Center and Infusion Centers in the four main hospitals. Versatile in all aspects of the Revenue Cycle through Final Claims Resolution. This position updates demographic and insurance information for accuracy on all patients. Collects and follows up on all accounts assigned prior to, during or after admission and discharge. Communicates hospital's findings back to the Physician, Nursing Team and Patient as appropriate. Identifies patients who require financial counseling intervention; provides information regarding resources for patients who need financial help after discharge and/or during collections and follow up activities. Verifies, researches and completes all paperwork and forms to bill all types of claims for reimbursement. This may include insurance company, drug replacement, and/or Pharmaceutical programs to help patients with their out of pocket expenses for drugs. Serves as a patient advocate during the cycle of the account. Assist with departmental workflow as needed. Identifies and notifies leadership of issues and initiates appropriate action for resolution. Communicates and provides feedback as needed to hospitals CFO, Managed Care, Finance and other leaders. Maintains thorough understanding of insurance, payment reimbursement, account reconciliation, referrals, authorizations, and account follow-up to secure reimbursement of claims. Provides support to leadership facilitating quality improvement by reporting problems, concerns, and opportunities for increased revenue and decreased denials. Assists in training and development of new staff members. Must be able to review and operationalize contracts as it relates to billing and reimbursement of claims, including infusion, transplant and institution accounts. The position is responsible for understanding and maintaining knowledge of standard for care of specific transplant population and the phases of donors and recipients. Reimbursement for donors and recipients have specific and unique regulatory and payer requirements for each phase from evaluation to post transplant based on the payer and /or type of donation. This position is responsible for assuring these are followed and completed for compliance and reimbursement. Provides liaison and educational services in support of standards. Identifies and resolves financial issues relating to all patients. Problem solving skills are required as the applicant must be able to use various tools, analyze the situation, research data and resolve and/or formulate a decision. Works closely with Management in formulating and implementing departmental objectives toward enhancing the work flow of the department. This position requires heavy phone and computer usage. In addition to the Hospital legacy system, the specialist will be using Microsoft Office Products, EPSI, Banking tools and various other online tools that vary for the insurance companies and stakeholders. Additionally, education sessions and insurance payor forums should be attended as appropriate. Position can serve as a trainer on providing education to others. Specialist may set up internal and external meetings with staff and payor representatives on a quarterly or as needed basis to discuss concerns relative to billing and proper payment of hospital. Services rendered. Specialist will assist in keeping Revenue Cycle Shared Drive for Emory Intranet link current with payor updates and trends as they occur. Specialist is required to review, analyze and understand the managed Care Contracts and various aspects of patient care to maximize reimbursement. The Revenue Cycle Specialist must be able to work independently and be self supervised. They must have excellent verbal, written, analytical and interpersonal communication skills. Professionalism must be maintained at all times regardless of circumstances. Organization skills are also very important. Other job duties as assigned pertinent to the Revenue Cycle. MINIMUM QUALIFICATONS: Bachelor's Degree with three years experience; Associate's Degree with five years experience; or seven years experience in Healthcare. Certified Patient Accounts Representative (CPAR) and/or Certified Patient Financial Counselor (CFC) required. PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks. ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks. Emory Healthcare Atlanta GA

Revenue Cycle Representative III

Expired Job

Piedmont Healthcare