Senior Rep - Revenue Cycle

Mayo Clinic • Phoenix, AZ

83d

About The Position

The Senior Revenue Cycle Rep is an experienced position within the Mayo Clinic enterprise Revenue Cycle team. This position will be responsible for ensuring accurate and appropriate actions to ensure payment integrity for Mayo Clinic services. This requires deep understanding of revenue cycle and payer policies and the ability to resolve complex issues. This position will be responsible for revenue cycle activities that require deep insight into claim processes and requiring comprehensive interpretation and understandings of payer contracts and industry standards. Incumbents must be comfortable with ambiguity, exhibit good decision making and judgment capabilities, and attention to detail. It is expected that staff are self-motivated, self-directed and highly organized and agree to promote a productive, collegial workplace. Staff should have the ability to prioritize work and handle a variety of tasks simultaneously. Belief in the mission and strong ethical conduct is essential. The position will require assertive communication with third party payer representatives and effective communication and coordination with necessary internal areas to ensure favorable outcomes for patients and the organization. In addition, the Senior Revenue Cycle Rep will take initiative to continuously learn within assigned job function to support progressive responsibility. This position will be responsible for interpreting data, drawing conclusions, review findings and provide recommendations for improvements. Maintain a growing knowledge of applicable State, Federal and local laws/regulations, correct billing and coding requirements including industry specific data such as modifiers, CPT and ICD-10 coding. This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit's performance expectations. Consistently document within the patient accounting system all actions and encounters leveraging necessary standard codes. Participates in special projects and other duties as directed by the Supervisor.

Requirements

• High School Diploma or GED required.
• Minimum five years of relevant healthcare, medical billing, financial clearance or denial management experience, or Bachelor's degree and minimum one year of relevant experience.
• Excellent written and verbal communication skills.
• Advanced financial and mathematical competencies.
• Analytical, problem-solving, and decision-making skills.
• Advanced computer/keyboarding skills.
• Competence and experience with Epic preferred.
• Advanced knowledge of medical billing and collections processes required.

Nice To Haves

• Associates degree or higher preferred.
• Radiation Oncology Prior Authorization and Denials experience preferred.
• Advanced knowledge of healthcare terminology preferred.
• Advanced knowledge of multiple payers preferred.
• Healthcare Financial Management Association (HFMA) Certification Preferred.

Responsibilities

• Ensure accurate and appropriate actions to ensure payment integrity for Mayo Clinic services.
• Resolve complex issues related to revenue cycle and payer policies.
• Interpret data, draw conclusions, review findings, and provide recommendations for improvements.
• Maintain knowledge of applicable State, Federal and local laws/regulations, billing and coding requirements.
• Document all actions and encounters within the patient accounting system.
• Communicate assertively with third party payer representatives.
• Coordinate effectively with internal areas to ensure favorable outcomes.
• Participate in special projects and other duties as directed by the Supervisor.

What This Job Offers

• Career Level: Mid Level
• Industry: Hospitals
• Education Level: High school or GED