Revenue Cycle Representative - Physician/Hospital Accounts Receivable Management (PHARM) - Patient Financial Services

UIOWA • Iowa City, IA

2d • Hybrid

About The Position

The University of Iowa Health Care department of Patient Financial Services is seeking a Revenue Cycle Representative (RCR) for an entry-level financial and insurance related position in the healthcare industry. Physician/Hospital Accounts Receivable Management (P/HARM) team members are divided among our sub-teams (i.e. Commercial Insurance, Medicare, Medicaid, and Hospital/Facility billing and Physician/Professional services billing). The P/HARM RCR will provide exceptional customer service to our external customers: patients, insurance contacts, etc; as well as internal customers. You will support our “Service Excellence” standards to all our customer groups, utilize tools and processes to make independent decisions and you will maintain integrity and treat internal and external customers respectfully. P/HARM RCR positions are primarily located in a high-volume web-based application environment, and you must have a demonstrated ability to prioritize, multi-task & quickly change focus in fast-paced team environment. P/HARM RCR positions can be a liaison to an assigned hospital department and must have the ability to exhibit compassion and empathy when working directly with patients and/or their families. This position is eligible to participate in remote work and applicants who wish to work remotely will be considered. Training will be held either ONSITE or via Hybrid (Inhouse/Zoom) from the HSSB building at a length determined by the supervisor. Remote eligibility will be evaluated upon a satisfactory job training opportunity. Per policy, work arrangements will be reviewed annually and must comply with the remote work program and related policies and employee travel policy when working at a remote location. University of Iowa Health Care — recognized as one of the best hospitals in the United States—is Iowa's only comprehensive academic medical center and a regional referral center. Each day more than 12,000 employees, students, and volunteers work together to provide safe, quality health care and excellent service for our patients. Simply stated, our mission is: Changing Medicine. Changing Lives.® WE CARE Core Values: Welcoming - We have an environment where everyone has a voice that is heard; that promotes the dignity of our patients, trainees, and employees; and allows all to thrive in their health, work, research, and education. Excellence - We achieve and deliver our personal and collective best in the pursuit of quality and accessible health care, education, and research. Collaboration - We collaborate with health care systems, providers, and communities across Iowa and the region as well as within our UI community. We believe teamwork—guided by compassion—is the best way to work. Accountability - We behave ethically, act with fairness and integrity, take responsibility for our own actions, and respond when errors in behavior or judgment occur. Respect - We create an environment where every individual feels safe, valued, and respected, supporting the well-being and success of all members of our community. Empowerment - We commit to fair access to research, health care, and education for our community and opportunities for personal and professional growth for our staff and learners.

Requirements

• Related customer service experience (typically 6 months or more) in a professional, financial, health care or medical related environment.
• Strong attention to detail with a proven ability to gather and analyze data and keep accurate records.
• Proficiency with computer software applications, i.e. Microsoft Office Suite (Excel, Word, Outlook, PowerPoint) or comparable programs and an ability to quickly learn and apply new systems knowledge.
• Demonstrated ability to handle complex and ambiguous situations with minimal supervision.
• Self-motivated with initiative to seek out additional responsibilities, tasks and projects.
• Bachelor’s degree; or equivalent combination of education and experience.

Nice To Haves

• Experience maintaining professionalism while handling difficult situations with callers or customers.
• Demonstrated ability to maintain or improve established productivity and quality requirements.
• Familiarity with medical terminology.
• Basic knowledge of Health Insurance Portability and Accountability Act (HIPAA) laws.
• Basic knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs.

Responsibilities

• Resolve claims from an assigned work-queue to ensure that all claims are worked within the timely filling/appeal guidelines.
• Determine if appropriate payment has been made by various entities; and/or work with patients and insurance companies, government entities (such as Centers for Medicare and Medicaid Services) to obtain correct payments; and/or appeal claim payments/denials.
• Perform denial management, research, obtain proper documentation to support resolution of overpayment, resolving credit balances and to resolve outstanding accounts receivable by interacting with third-party entities via websites, telephone, or written inquiries.
• Identify & report undesirable trends and reimbursement modeling errors or underlying causes of incorrect payment; review allowed variances from third party payers.
• Be expected to maintain a high-level of accuracy to meet productivity and quality requirements.
• Identify trends and/or work processes for potential process improvements.
• Review and analyze report data to provide status updates to leadership.
• Communicate with providers, payers, patients, internal departments, co-workers, and Coordinator’s to resolve issues.
• Communicate changes in payor policies and denial trends; escalates claim payment delays as appropriate.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Number of Employees: 5,001-10,000 employees