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

Job Summary:

The Credits Revenue Cycle Representative (RCR) is an entry-level financial and insurance related position in the healthcare industry.   Physician/Hospital Accounts Receivable Management (P/HARM) team members are divided among our sub-teams (i.e.  Commercial Insurance, Medicare, Medicaid, and Hospital/Facility billing and Physician/Professional services billing). 

The P/HARM RCR will provide exceptional customer service to our external customers: patients, insurance contacts, etc; as well as internal customers.  You will support our “Service Excellence” standards to all our customer groups, utilize tools and processes to make independent decisions and you will maintain integrity and treat internal and external customers respectfully. 

 P/HARM RCR positions are primarily located in a high volume web-based application environment and you must have a demonstrated ability to prioritize, multi-task & quickly change focus in fast-paced team environment.  P/HARM RCR positions can be a liaison to an assigned hospital department and must have the ability to exhibit compassion and empathy when working directly with patients and/or their families.

This position is primarily a combination of remote and onsite (hybrid) work locations.  Remote work must be performed at an offsite location within the State of Iowa.  Training will be held either on ONSITE at the HSSB building or via zoom, with location and length of training determined by the supervisor.  Remote eligibility will be evaluated upon a satisfactory job training opportunity.  Per policy, work arrangements will be reviewed annually, and must comply with the remote work program and related policies and employee travel policy when working at a remote location.

Position Responsibilities: 

• Resolve credits from over-payments and undistributed from an assigned work-queue to ensure that all claims are worked within the timely filling/appeal guidelines.
• Determine if appropriate payment has been made by various entities; and/or work with patients and insurance companies, government entities (such as Centers for Medicare and Medicaid Services)  to correctly resolve over payment issues; and/or appeal claim payments/denials.
• Perform account management,  research, obtain proper documentation to support resolution of overpayment; resolving credit balances and to resolve outstanding accounts receivable by interacting with third-party entities via websites, telephone, or written inquiries.
• Identify & report undesirable trends and reimbursement modeling errors or underlying causes of incorrect payment; review allowed variances from third party payers.
• Be expected to maintain a high-level of accuracy to meet productivity and quality requirements.
• Identify trends and/or work processes for potential process improvements.
• Review and analyze report data to provide status updates to leadership.
• Communicate with providers, payers, patients, internal departments, co-workers and Coordinator’s to resolve issues.
  •  Communicate changes in payor policies and denial trends; escalates claim payment delays as appropriate.

Classification Title: Revenue Cycle Representative - Credits

Department: Patient Financial Services

Staff Type: Professional & Scientific

Type of Position: Regular

Pay Grade: 2B

Percent of Time: 100%

Location: Hospital Support Services Building (HSSB)

This position is primarily a combination of remote and onsite (hybrid) work locations.  Remote work must be performed at an offsite location within the State of Iowa.  Training will be held either on ONSITE at the HSSB building or via zoom, with location and length of training determined by the supervisor.  Remote eligibility will be evaluated upon a satisfactory job training opportunity.  Per policy, work arrangements will be reviewed annually, and must comply with the remote work program and related policies and employee travel policy when working at a remote location.

Equipment

Onsite – The department will provide a workstation which contains 3 (three) monitors, laptop/power cord, docking station/power cord, keyboard, mouse, headset, and desk supplies can be found in the supply closet.

Hybrid – while working onsite, the department will provide a workstation which contains 3 (three) monitors, a laptop/power cord, docking station/power cord, keyboard, mouse, headset, and desk supplies. When working offsite, the employee will take their laptop/power cord to carry back and forth, a second docking station/power cord to keep offsite. Prior to working offsite, the employee, at their own expense, will need to supply 2 (two) monitors, a keyboard, a mouse, and provide a screen shot of the domicile internet speed (minimum 30mb download and 10mb upload) and a picture of the office setup.

Remote - when working offsite, the department will provide the employee a laptop/power cord, docking station/power cord, headset. Prior to working offsite, the employee, at their own expense, will need to supply 2 (two) monitors, a keyboard, a mouse, and provide a screen shot of the domicile internet speed (minimum 30mb download and 10mb upload) and a picture of the office setup.