Billing Representative Revenue Cycle Management

Ascension•Austin, TX

22h•$20 - $27•Remote

About The Position

This role focuses on Revenue Cycle Management, specifically handling denied claims and ensuring efficient revenue recovery. The Billing Representative will execute strategic denial management, conduct deep-dive reviews, and implement resolution strategies. They will also be responsible for revenue recovery initiatives, working outstanding and denied claims to minimize aging accounts receivable and maximize departmental cash flow. A key aspect of the role involves serving as a Payer Relations Liaison, using communication skills to negotiate and resolve billing disputes with insurance payers. Additionally, the representative will analyze clinical documentation and medical records to support appeals and ensure compliance with insurance requirements. Maintaining technical agility to adapt to changing payer regulations and software updates is crucial for an uninterrupted revenue cycle. The role also includes collaborating for process improvement by reporting on denial trends and providing insights to leadership.

Requirements

High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.
Required professional licensure/certification can be used in lieu of education or experience, if applicable.
A minimum of two years of direct experience specifically focused on analyzing and overturning insurance claim denials.
Extensive experience working directly with a diverse range of insurance payers and a thorough understanding of their unique reimbursement policies.
The ability to articulate complex billing issues clearly to both internal stakeholders and external insurance representatives.
A "fast learner" mindset with the ability to quickly master new EMR/EHR systems and billing software workflows.
High-level problem-solving skills with a meticulous eye for detail when reviewing rejected claims.

Responsibilities

Conduct deep-dive reviews and analysis of denied claims to identify root causes and implement effective resolution strategies.
Aggressively "work" outstanding and denied claims to minimize aging accounts receivable and maximize departmental cash flow.
Leverage expert-level communication skills to negotiate and resolve complex billing disputes directly with insurance payers.
Evaluate medical records and payer policies to ensure that appeals are supported by accurate data and meet specific insurance requirements.
Rapidly adapt to changing payer regulations and internal software updates to ensure the revenue cycle remains uninterrupted.
Report on denial trends to leadership, providing actionable insights to prevent future claim rejections.