Description:
RESPONSIBLE FOR:
The Revenue Cycle Representative is a multi-task position that covers all of the main functions of the Central Business Office. The Revenue Cycle Representative Two has displayed the skill to accurately handle at least one unit function of the Central Business Office for at least two years.
Included in these duties but not limited to: Insurance Follow Up, Self-Pay Follow Up, Payment Posting, Account Correction and Adjustment, Answering Patient Account Inquires, and Monitoring Billing Errors and claim/line item rejections.
Provide initial training in all duties of the Central Business Office in an elementary phase. Position is designed to develop the incumbent into a Revenue Cycle Representative Three after training for two additional years of acceptable performance before promotion to a Revenue Cycle Representative Two must be able to handle the complete functions of at least one Central Business Office Unit.
KEY RESPONSIBILITIES:
Revenue Cycle Representative Duties:
Customer Service Duties:
Answer and resolve all incoming calls regarding patient accounts in a timely and professional manner.
Work effectively and efficiently to minimize the number of abandoned calls
Record each phone call on a daily log sheet and turn into the Supervisor at the end of each day.
Assure wait time per call is kept to a minimum
Contact patients regarding their self pay balances. Turn inbound calls in to collection calls.
Return patient calls with your results in 24 hours or less
Handle customer service calls in less then two minutes.
Payment Posting Duties:
Accurately post payments and adjustments to the patients account.
Balance payment batches to bank deposit.
Audit batch for accuracy.
Index explanation of benefits to visit in scanning system.
Follow Up Duties Insurance and Patient Pay:
Review and work the entire account and not just a particular visit.
Follow Up with Third Payers in order to facilitate payment of claim.
Work from the assigned task lists by Financial Class. Accounts are aged by each individual Financial Class.
Work correspondence from insurance payers and patients on a daily basis. Refer items that need the attention of the practice to the practice.
Assure the patients account is properly worked and information is updated in the system
Appeal payments when claim is not paid according to the fee schedule.
Refile claims as needed
Make adjustments as needed
Correct claims and refile as needed to ensure proper payment
Correct discrepancies in the line times to merge debits and credits and create a true account balance.
Identify and report billing errors and non-payment trends to management.
Visit notes must be documented on all telephone contacts and transaction postings
May require special projects, overtime and/or changes in job descriptions at the discretion of your Team Lead
Research and resolve all billing problems in a timely manner
Turn in productivity on a daily basis/A minimum of 60 visits must be completed per 8 hour work day
Back up Customer Service when necessary/Work as a team player
Qualifications:
MINIMUM EDUCATION REQUIRED:
Require High School Diploma or general education degree (GED).
MINIMUM EXPERIENCE REQUIRED:
Two (2) years related experience; or equivalent combination of education and experience.
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
None
ADDITIONAL QUALIFICATIONS:
Moderate knowledge of third party insurance in regards to plan types: HMO, PPO, POS, and Indemnity. Moderate knowledge of the Medicare Program particularly as it relates to CPT and ICD9 coding CPT. Through knowledge of Medicare Fraud and Abuse regulations. Has the ability to financially counsel patients regarding their outstanding charges and effectively resolve problems while maintaining a positive public relations image for the practice. Possesses moderate knowledge of Next Gen Practice Management system. Possess full 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.
#GD #LI-POST