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Revenue Cycle Regional Rep 2
Carle • Remote • Posted 3 days ago
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Remote • Full-time • Junior Level
Job Highlights
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The Revenue Cycle Regional Representative 2 is responsible for handling escalated account and payer issues, including complex edits, appeals, and account activities such as advanced level tasks, bankruptcies, and Risk Management. This role acts as a billing and reimbursement expert for a defined payer product line and requires proficiency in Microsoft Office applications and Receivables Management systems.
Responsibilities
- Perform essential job functions of Revenue Cycle Regional Representative 1.
- Handle complex edits, correspondence, and advanced level workqueues such as retro review, EOB balancing, credit adjustment review, and processing of Illinois Workers' Compensation Commission (IWCC).
- Handle escalated account activities such as healthcare liens, settlement requests, workers' compensation reimbursement computation forms, and attorney requests.
- Handle escalated appeals.
- Assist with training and education to staff for accuracy.
- Identify payer and system issues to initiate project requests for process improvements.
- Assist in credit balance review according to organization's credit balance/refund policy.
- Attend and participate in meetings with payer specific provider representatives to maximize reimbursement and minimize denials through problem solving, collaboration, and consensus.
Qualifications
Required
- One year customer service experience in health care.
- Proficient computer knowledge related to Microsoft Office applications such as Word, Excel, Outlook, and Receivables Management systems.
- Knowledge of basic medical coding and third-party operating procedures and practices with proficiency in EncoderPro.
Preferred
- Associate's degree.
- Credit and collection experience.
Full Job Description
Revenue Cycle Regional Rep 2
+ Department: Revenue Cycle - CFH_10_19
+ Entity: Bloomington-Normal Service Area
+ Job Category: Clerical/Admin
+ Employment Type: Full - Time
+ Job ID: 45671
+ Experience Required: 1 - 3 Years
+ Education Required: HS Diploma/GED
+ Shift: Day
+ Location: Urbana, IL
+ Usual Schedule: M-F 8am-4:30pm
+ On Call Requirements: No
+ Work Location: Working from Home
+ Weekend Requirements: No
+ Holiday Requirements: No
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Position Summary:
Proficient in Revenue Cycle Regional Representative 1. Responsible for handling escalated account and payer issues. Handles complex edits, appeals and account activities such as advanced level tasks, bankruptcies, Risk Management. Acts as a billing and reimbursement expert for a defined payer product line.
Qualifications:
EDUCATIONAL REQUIREMENTS Associate's degree preferred. CERTIFICATION & LICENSURE REQUIREMENTS None specified EXPERIENCE REQUIREMENTS One year customer service experience in health care required or a high performer as an Rev Cycle Regional Representative 1. Credit and collection experience preferred. Proficient computer knowledge related to Microsoft Office applications such as Word, Excel, Outlook and Receivables Management systems. SKILLS AND KNOWLEDGE Possesses the "other knowledge and skills" of the Revenue Cycle Regional Representative 1. Knowledge of basic medical coding and third-party operating procedures and practices with proficiency in EncoderPro.
Essential Functions:
+ Must be able to perform essential job functions of Revenue Cycle Regional Representative 1.
+ Handles complex edits, correspondence and advanced level workqueues such as but not limited to retro review, EOB balancing, credit adjustment review and processing of Illinois Workers' Compensation Commission (IWCC).
+ Handles escalated account activities such as but not limited to healthcare liens, settlement requests, workers' compensation reimbursement computation forms and attorney requests.
+ Handles escalated appeals.
+ Assists with training and education to staff for accuracy.
+ Identifies payer and system issues to initiate project requests for process improvements.
+ Assists in credit balance review according to organization's credit balance/refund policy.
+ Attends and participates in meetings with payer specific provider representatives to maximize reimbursement and minimize denials through problem solving, collaboration and consensus.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: human.resources@carle.com.
Effective September 20, 2021, the COVID 19 vaccine is required for all new Carle Health team members. Requests for medical or religious exemption will be permitted.
+ Department: Revenue Cycle - CFH_10_19
+ Entity: Bloomington-Normal Service Area
+ Job Category: Clerical/Admin
+ Employment Type: Full - Time
+ Job ID: 45671
+ Experience Required: 1 - 3 Years
+ Education Required: HS Diploma/GED
+ Shift: Day
+ Location: Urbana, IL
+ Usual Schedule: M-F 8am-4:30pm
+ On Call Requirements: No
+ Work Location: Working from Home
+ Weekend Requirements: No
+ Holiday Requirements: No
Email a Friend Save Save Apply Now
Position Summary:
Proficient in Revenue Cycle Regional Representative 1. Responsible for handling escalated account and payer issues. Handles complex edits, appeals and account activities such as advanced level tasks, bankruptcies, Risk Management. Acts as a billing and reimbursement expert for a defined payer product line.
Qualifications:
EDUCATIONAL REQUIREMENTS Associate's degree preferred. CERTIFICATION & LICENSURE REQUIREMENTS None specified EXPERIENCE REQUIREMENTS One year customer service experience in health care required or a high performer as an Rev Cycle Regional Representative 1. Credit and collection experience preferred. Proficient computer knowledge related to Microsoft Office applications such as Word, Excel, Outlook and Receivables Management systems. SKILLS AND KNOWLEDGE Possesses the "other knowledge and skills" of the Revenue Cycle Regional Representative 1. Knowledge of basic medical coding and third-party operating procedures and practices with proficiency in EncoderPro.
Essential Functions:
+ Must be able to perform essential job functions of Revenue Cycle Regional Representative 1.
+ Handles complex edits, correspondence and advanced level workqueues such as but not limited to retro review, EOB balancing, credit adjustment review and processing of Illinois Workers' Compensation Commission (IWCC).
+ Handles escalated account activities such as but not limited to healthcare liens, settlement requests, workers' compensation reimbursement computation forms and attorney requests.
+ Handles escalated appeals.
+ Assists with training and education to staff for accuracy.
+ Identifies payer and system issues to initiate project requests for process improvements.
+ Assists in credit balance review according to organization's credit balance/refund policy.
+ Attends and participates in meetings with payer specific provider representatives to maximize reimbursement and minimize denials through problem solving, collaboration and consensus.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: human.resources@carle.com.
Effective September 20, 2021, the COVID 19 vaccine is required for all new Carle Health team members. Requests for medical or religious exemption will be permitted.
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