Revenue Cycle Representative III

Piedmont Healthcare Inc. • Atlanta, GA

1d

About The Position

The Revenue Cycle Representative III is an advanced, multi-tasking role encompassing key functions across the physician billing revenue cycle. The representative applies advanced revenue cycle knowledge gained through experience, training, and education, and supports patient-centered care by advocating for patients throughout the account life cycle. Productivity is expected to exceed the department’s average standard, and audited work quality and accuracy are expected to consistently exceed 90%. Performance is measured against Piedmont Healthcare’s values of Compassion, Commitment, Service, Excellence, and Balance, with performance expected to rank in the department’s top third. The representative is proficient in one or more advanced revenue cycle functions beyond core responsibilities.

Requirements

• High school graduate or GED.
• At least 5 years of experience demonstrating advanced performance in a physician billing revenue cycle or Central Business Office.
• Advanced knowledge of third-party insurance plan types, including HMO, PPO, POS, and indemnity.
• Excellent knowledge of the Medicare program, particularly as it relates to CPT and ICD-9 coding.
• Thorough knowledge of Medicare Fraud and Abuse regulations.
• Ability to counsel patients financially regarding outstanding charges and effectively resolve problems with a high level of customer service and etiquette.
• Advanced knowledge of the Practice Management System.
• Ability to run standard reports to answer questions from practice managers and physicians.
• Thorough knowledge of HIPAA regulations.
• Proficiency with practice computer systems, including the Practice Management System, internet products related to office functions, and Microsoft Office systems.

Responsibilities

• Perform core revenue cycle functions, including billing, claims filing, data entry, charge entry, insurance follow-up, self-pay follow-up, denial management, payment posting, refund management, credit balance management, account correction and adjustment, patient account inquiry response, customer service advocacy, self-pay collections, and unapplied cash management.
• Perform advanced revenue cycle functions, which may include file maintenance, system support, claims edit management, claims rejection management, front-end management, and payment variance management.
• Advocate for patients throughout the account life cycle and provide patient-centered customer service.
• Maintain productivity above the department’s average standard and consistently achieve audited work quality and accuracy above 90%.
• Counsel patients financially regarding outstanding charges and resolve problems using strong customer service skills.
• Run standard reports to answer questions from practice managers and physicians.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED