Overview
A healthcare organization is seeking a Revenue Cycle Representative for the Physician Hospital Accounts Receivable Management (PHARM) team within the Patient Financial Services department. This role focuses on complex billing issues related to Workers Compensation as part of the financial and insurance services in healthcare.
The position involves retrospective analysis of claims and billing activities including registration, coding, billing, payment posting, credits, self-pay billing, denials, and contractual compliance.
This role is eligible for remote work within Iowa. Training will be conducted onsite or via Zoom from the Hospital Support Services Building (HSSB) in Coralville, IA. Remote work eligibility will be evaluated after successful completion of training and must comply with the organization's remote work policies.
Responsibilities
- Resolve claims from an assigned work queue ensuring timely filing and appeal guidelines are met.
- Verify appropriate payments from various entities including patients, insurance companies, and government agencies such as CMS.
- Manage denials, research claims, obtain documentation to resolve overpayments, credit balances, and outstanding accounts receivable.
- Identify and report trends, reimbursement errors, and causes of incorrect payments.
- Maintain high accuracy to meet productivity and quality standards.
- Recommend process improvements based on trend analysis.
- Review and analyze report data to provide status updates to leadership.
- Communicate with providers, payers, patients, internal departments, and coordinators to resolve issues.
- Inform stakeholders of changes in payer policies and denial trends; escalate payment delays as needed.
Requirements
- Bachelor’s degree or equivalent combination of education and experience.
- At least 6 months of related customer service experience in a professional, financial, healthcare, or medical environment.
- Strong attention to detail with ability to gather, analyze data, and maintain accurate records.
- Proficiency with Microsoft Office Suite (Excel, Word, Outlook, PowerPoint) or comparable software.
- Ability to quickly learn and apply new systems.
- Demonstrated ability to handle complex and ambiguous situations with minimal supervision.
- Self-motivated with initiative to take on additional responsibilities.
Preferred Qualifications
- Experience maintaining professionalism in difficult customer interactions.
- Proven ability to meet or exceed productivity and quality requirements.
- Familiarity with medical terminology.
- Basic knowledge of HIPAA regulations.
- Basic understanding of healthcare billing, insurance, and federal/state assistance programs.
Compensation & Benefits
- Pay Grade: 2B
- Full-time position, Monday through Friday, 8:00 a.m. to 5:00 p.m.
Location & Work Modality
- Position is remote eligible within Iowa only.
- Training conducted onsite at the Hospital Support Services Building (HSSB) in Coralville, IA or via Zoom.
Equipment Provided
- Onsite: Workstation with three monitors, laptop, docking station, keyboard, mouse, headset, and desk supplies.
- Hybrid: Same as onsite when working onsite; when remote, employee must provide two monitors, keyboard, and mouse at their own expense. The organization provides laptop, docking station, headset, and power cords.
- Remote: Employee must provide two monitors, keyboard, and mouse at their own expense. The organization provides laptop, docking station, headset, and power cords.
Employees working remotely must submit a photo of their home office setup and perform an internet speed test with minimum 30 Mbps download and 10 Mbps upload speeds reflecting the organization's IP address.
Application Process
Applicants must upload a resume and may optionally include a cover letter. Applications are accepted for a minimum of 7 calendar days and may close earlier if the position is filled.
Successful candidates will be required to disclose conviction history, undergo a criminal background check, and have credentials and education verified. Up to five professional references may be requested later in the process.
Additional Information
- Classification Title: Revenue Cycle Representative (Workers Comp)
- Department: Patient Financial Services (PHARM)
- Appointment Type: Professional and Scientific
- Schedule: Full-time
- Work Modality: Remote within Iowa only
For assistance with the application process, an Applicant Resource Center is available Monday through Friday from 10:00 a.m. to 4:00 p.m. or by appointment.