Future Revenue Cycle Representative

** We currently have our revenue cycle representative positions full. However, we are accepting applications for future openings. **

Role: Revenue Cycle Representative

Location: Remote. Must work in a location within the United States.

Travel: No travel required

Classification: Hourly, Non-Exempt

Reports to: Revenue Cycle Leadership

Salary Range: Commensurate with experience 

about the role

The Revenue Cycle Representative (RCR) role may be responsible for billing and claim edits, insurance follow up, credit resolution, and payment posting functions to ensure accurate and timely reimbursement for revology clients. An effective RCR will be a creative problem-solver with a critical eye for details and an attitude of service. What makes this role at revology different from other Revenue Cycle Representative positions?  These revologists will also have the unique opportunity to provide feedback on the build of revology products and solutions to enhance the end user experience.  The specific responsibilities of each Revenue Cycle Representative position will depend on client assignment, but will consist of many / all of the following activities. 

responsibilities

• Resolve and/or remedy claim errors, edits and rejections to ensure proper and timely submission to payers. 
• Follow up with insurance companies regarding the status of outstanding claims and pursue appropriate steps for remedy. 
• Review and respond to insurance correspondence as needed to ensure complete and accurate reimbursement. 
• Compose highly-detailed correspondence such as appeal forms, claim forms and other client- and/or patient-facing correspondence.
• Engage with patients and/or guarantors as needed to provide guidance on proper resolution of insurance claim balances. Demonstrate service mindset in all interactions.
• Receive and review payments from various sources (including patients and payers) and accurately post into the EHR or organizational billing system.  Apply payments to patient accounts appropriately based on explanations of benefits (EOBs), remittance advice, and other payment documentation.
• Identify and rectify posting errors, misapplied payments, or duplicate payments promptly.
• Maintain credentialing files and ensure compliance with credentialing standards and regulatory requirements, including gathering required documentation and completing credentialing applications.
• Resolve outstanding credit balances timely to ensure compliance with payer and / or organizational guidelines.
• Obtain prior authorizations from payers based on provider orders to ensure timely patient care and minimize authorization-related denials.
• Be resourceful to maintain working knowledge of payer rules and regulations applicable to assigned work.
• Provide input and feedback on revology products and solutions through early adoption of use to enhance the end user experience.
• Consistently achieve productivity and quality metrics.
• Navigate several computer applications simultaneously; document all actions taken in appropriate revology and/or client systems.
• Comply with and hold with utmost regard all compliance requirements to protect patient privacy and confidentiality. 
• Stay curious, kind and contribute positively to the revology culture. The health + harmony of the team is everybody’s responsibility at revology.

The statements stated in this job description reflect the general duties as necessary to describe the basic function, essential job duties/responsibilities, job requirements, physical requirements and working conditions typically required, and should not be considered an all-inclusive listing of the job.  Individuals may perform other duties as assigned, including work in other functional areas to cover absences or relief, to equalize peak work periods or otherwise balance the workload.

requirements

• 3+ years of healthcare billing and insurance experience required.
• Knowledge of and/or experience with EOBs, CPT & ICD-10 codes, health insurance claims, authorizations/referrals highly preferred.
• Ability to work independently to accomplish goals in a dynamic environment.
• High school diploma or equivalent required; bachelor’s degree or equivalent experience preferred.
• An aptitude for problem-solving, patience and flexibility while working in the complex industry of healthcare revenue cycle. 
• Ability to comfortably navigate a technology-focused setup to efficiently complete assigned work (multiple monitors + several applications open simultaneously).

remote work requirements

Internet capability must be a high-speed internet connection.

physical requirements

Must be able to perform physical activities, such as, but not limited to: moving or handling (lifting, pushing, pulling and reaching overhead) office equipment and supplies weighing 1 to 25 lbs. unassisted.  Frequently required to sit for extended periods during the workday.  Manual dexterity and visual acuity required.  Must be able to communicate effectively on the telephone and in person.

working conditions

Work will generally be performed indoors in an office environment.  Must maintain a professional appearance and manner.  

employment eligibility

Candidates must be legally authorized to work in the United States without sponsorship.