JOB TITLE: Revenue Cycle Billing Representative

DEPARTMENT: Patient Financial Services-Revenue Cycle

REPORTS TO: Revenue Cycle Director/Manager of PFS

JOB SUMMARY

The Revenue Cycle Billing Representative is responsible for performing a variety of complex duties, including but not limited to, maintaining pre-billing functions, working outstanding insurance claims that have no response from payers, having claim edits, and/or having received claim form related denials. Work with vendor to ensure A/R remains at acceptable aging levels by prompt follow-up of unpaid claims and denied claims. Timely resolution of credit balances. Addresses customer issues or concerns related to billing. Participate in revenue integrity and analysis of the revenue cycle areas for all Cody Regional Health sites and locations as assigned.

JOB REQUIREMENTS

Will accept any combination of formal education and or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential task of the job. High School diploma or GED preferred.

EXPERIENCE

Experience in hospital setting, physician office and financial area preferred. Physician office, registrations, pre-registration experience preferred. Must have excellent communication skills. Cash collections experience preferred. Insurance related experience preferred.

SKILLS

• Must possess a high degree of confidentiality of all matters with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
• Must have strong interpersonal skills with the ability to communicate with staff and public in a friendly, courteous and helpful manner.
• Must have excellent organizational skills with the ability to multi-task.
• Must have well-developed verbal and written communication skills.
• Read and interpret EOB’s (Explanation of Benefits).
• Maintain basic understanding and knowledge of health insurance plans, policies, and procedures.
• Experience with insurance company prior authorizations preferred.
• Ability to adapt to fluctuations in workload, and work efficiently and effectively under stressful conditions.
• Willingness to assume additional duties when requested and seek guidance and direction, when needed, for performance of duties and ability to recognize, establish and respond to priorities.
• Strong computer and keyboarding skills.
• Must be proficient in the use of Microsoft Office Suite products knowledge including Word, Excel and Outlook.
• Ability to learn new computer software applications.
• Competence in CRH EMR.
• Must have analytical thinking skills.
• Accurate and systematical filing skills.
• Must know medical terminology.
• Detail oriented.
• Exceptional phone etiquette.
• Must be self-motivated.
• Accountability for the consequences of own actions.

REQUIRED CERTIFICATIONS

• Certified Revenue Cycle Representative within 6 months of hire.
• Other HFMA Certifications as appropriate.