Senior Rep-Revenue Cycle-Hybrid

Mayo Clinic•Rochester, MN

12h•$29 - $40•Hybrid

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. This role requires the ability to effectively manage escalated client accounts, troubleshoot and resolve system issues, and navigate multiple websites and systems simultaneously in a fast-paced environment. The successful candidate will also support operational excellence by maintaining and updating standard operating procedures (SOPs), providing training and ongoing education to team members, and assisting with daily departmental responsibilities during staff absences. Strong organizational skills, attention to detail, and the ability to balance multiple priorities while supporting both the Client Representative and Payment Processing teams are essential for success in this position.

Requirements

Deep understanding of revenue cycle and payer policies.
Ability to resolve complex issues.
Deep insight into claim processes.
Comprehensive interpretation and understanding of payer contracts and industry standards.
Comfortable with ambiguity.
Good decision making and judgment capabilities.
Attention to detail.
Self-motivated, self-directed, and highly organized.
Ability to prioritize work and handle a variety of tasks simultaneously.
Belief in the mission and strong ethical conduct.
Assertive communication with third party payer representatives.
Effective communication and coordination with necessary internal areas.
Ability to continuously learn within assigned job function.
Ability to effectively manage escalated client accounts.
Ability to troubleshoot and resolve system issues.
Ability to navigate multiple websites and systems simultaneously in a fast-paced environment.
Strong organizational skills.
Ability to balance multiple priorities.

Responsibilities

Ensuring accurate and appropriate actions to ensure payment integrity for Mayo Clinic services.
Resolving complex issues related to revenue cycle and payer policies.
Interpreting payer contracts and industry standards.
Interpreting data, drawing conclusions, reviewing findings, and providing recommendations for improvements.
Maintaining 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.
Adhering to quality assurance guidelines and established productivity standards.
Documenting all actions and encounters within the patient accounting system.
Participating in special projects and other duties as directed by the Supervisor.
Effectively managing escalated client accounts.
Troubleshooting and resolving system issues.
Navigating multiple websites and systems simultaneously in a fast-paced environment.
Maintaining and updating standard operating procedures (SOPs).
Providing training and ongoing education to team members.
Assisting with daily departmental responsibilities during staff absences.