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Senior Revenue Cycle Representative
2 months ago
Overview:
The individual in this role is tasked with supporting the Revenue Cycle department at CHRISTUS Health. This position is pivotal in ensuring timely and efficient processing of patient accounts, focusing on the resolution and reconciliation of outstanding balances. Collaboration within a team environment is essential to deliver exceptional service to both internal and external stakeholders.
The associate is expected to uphold the highest ethical standards and act in alignment with CHRISTUS Health's Mission, Philosophy, and core values, which include Dignity, Integrity, Compassion, Excellence, and Stewardship.
Key Responsibilities:
• Adhere to the OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Execute Revenue Cycle tasks that meet or surpass CHRISTUS Health's performance metrics.
• Ensure compliance with departmental quality and productivity benchmarks.
• Gather and relay patient and payer information to aid in account resolution.
• Address all forms of account inquiries through various communication methods.
• Maintain up-to-date knowledge of insurance and self-pay billing guidelines for third-party payers. Stay informed about all functions within the Revenue Cycle.
• Communicate professionally and effectively with both internal and external customers to resolve outstanding account questions.
• Meet or exceed customer expectations, fostering trust and respect.
• Comply with all regulations set forth by CHRISTUS Health, payers, and government entities.
• Demonstrate a solid understanding of CPT, HCPCS, and ICD-10 coding standards.
• Accurately document activities in the patient accounting system as per established policies and procedures.
• Provide ongoing updates to the PFS Leadership Team regarding issues impacting productivity, reimbursement, and patient experience.
• Exhibit strong written and verbal communication skills.
Billing Duties
• Review and address claim edits.
• Manage payer-rejected claims for resubmission.
• Handle reports and billing requests efficiently.
• Demonstrate comprehensive knowledge of standard billing forms and submission requirements.
• Understand electronic claims editing and submission processes.
Collections Duties
• Collect outstanding balances from payers to ensure proper reimbursement for services rendered.
• Identify and relay denial information to the appropriate departmental liaison, focusing on timely resolution.
• Maintain current knowledge of all collection requirements from payers.
• Utilize the collector queue daily, employing the appropriate collection systems and reports.
• Recognize and resolve underpayments and credit balances promptly.
• Identify trends affecting account resolution and communicate them effectively.
Cash Reconciliation Duties
• Ensure accurate and timely posting of all payments through reconciliation of the patient accounting system and bank statements.
• Verify patient account numbers and facilities for submitted cash payments.
• Conduct cash reconciliations to detect posting errors and ensure all receipts align with daily deposits and monthly statements.
• Address and resolve patient complaints and inquiries from various departments and partners.
• Investigate unapplied cash, maintaining follow-up until payment identification is achieved.
Qualifications:
- High School Diploma or equivalent experience required.
- Post-secondary education preferred.
- 3-5 years of relevant experience preferred.
- Experience in a multi-facility hospital business office environment is advantageous.
- College education or previous experience with insurance claims and/or healthcare billing training may substitute for formal hospital experience.
- Familiarity with patient and outpatient billing requirements for UB-04 and HCFA 1500 forms is preferred.
Work Schedule:
TBD
Work Type:
Full Time
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