Revenue Cycle Representative (Insurance Follow-Up) - Physician/Hospital Accounts Receivable Management (PHARM) - Patient Financial Services

About the position

The Revenue Cycle Representative (RCR) is an entry-level position focused on financial and insurance processes within the healthcare industry. This role involves providing exceptional customer service to both external and internal customers while supporting the organization's service excellence standards. The RCR will work primarily in a hybrid environment, balancing remote and onsite responsibilities, and will be responsible for resolving claims, managing denials, and ensuring accurate payments from various entities.

Responsibilities
?? Resolve claims from an assigned work-queue to ensure timely processing within guidelines.
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?? Determine appropriate payments made by various entities and work with patients and insurance companies to obtain correct payments.
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?? Perform denial management and research to resolve outstanding accounts receivable.
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?? Identify and report undesirable trends and reimbursement modeling errors.
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?? Maintain a high level of accuracy to meet productivity and quality requirements.
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?? Review and analyze report data to provide status updates to leadership.
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?? Communicate with providers, payers, patients, and internal departments to resolve issues.

Requirements
?? Bachelor's degree or equivalent combination of education and experience.
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?? Related customer service experience (typically 6 months or more) in a professional, financial, healthcare, or medical-related environment.
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?? Strong attention to detail with the ability to gather and analyze data accurately.
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?? Proficiency with computer software applications, including Microsoft Office Suite.
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?? Demonstrated ability to handle complex situations with minimal supervision.
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?? Self-motivated with initiative to seek out additional responsibilities.

Nice-to-haves
?? Experience maintaining professionalism while handling difficult situations with customers.
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?? Demonstrated ability to maintain or improve established productivity and quality requirements.
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?? Familiarity with medical terminology.
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?? Basic knowledge of HIPAA laws and healthcare billing processes.

Benefits
?? Hybrid work environment with remote work options.
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?? Training provided either onsite or via Zoom.
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?? Workstation provided with necessary equipment for onsite work.

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