Job Details
Revenue Cycle Representative
Raleigh, NC
(Hybrid position. Two days per week in office required)
Essential Functions:
- Provide direct support to patients and/or customers regarding coverage for company related services including updates on claim status, billing inquiries, coding issues, etc.
- Answer calls from physician offices, hospitals, and patients using exemplary customer service skills.
- Verify accuracy of billing data and revise errors.
- Post all credit and debit adjustments to accounts with adherence to company guidelines.
- File all charge, payment and adjustment batches in the appropriate format per departmental guidelines.
- Follow up on all outstanding claims at 30, 60, 90+ days from date of service per department protocols with an emphasis on maximizing patient satisfaction and company profits for both insurance and patient due balances.
- Follow up on all returned claims, denials, correspondence, account reconciliations and rebills within 5 business days of receipt of information/request to achieve maximum reimbursement in a timely manner.
- Review for and request approval for bad debt write offs per company policy.
- Provide feedback and information to other reimbursement staff to ensure accuracy and timely reimbursement pertaining to billing, coding, carriers and other related information.
- Monitor insurance fee schedules and plan requirements for company related services.
- Proficiency with all revenue cycle representative role responsibilities.
- Maintain patient confidentiality as defined by state, federal and company regulations.
- Establish effective rapport and maintain cooperative working relationships with other employees, professional support service staff, customers, clients, patients, families and physicians or other healthcare providers.
- Actively support departmental and corporate strategic plans and ensure successful implementation.
- Perform day to day administrative functions and general office duties related to the reimbursement department.
- Practices confidentiality and privacy protocols in accordance with company policies and HIPAA requirements.
- Exercises problem-solving and conflict resolution skills when handling patient complaints.