Revenue Cycle Representative Remote USA

Industry: Private

Employment Type:- Full Time

Work Hours:-  8 Hours

Locations:- USA

Full Job Description:-

The vision of Clinical Health Network for Transformation (CHN) is to better fulfill the mission and promise of Planned Parenthood to bring high-quality, affordable care to every member of our communities. CHN is a collaboration between Planned Parenthood affiliates across the United States.

CHN is looking for individuals who are committed to supporting our shared goal of strengthening and enhancing our awareness and commitment to advancing the cause of health and race equity in our organization.

Reporting directly to the Revenue Cycle Manager, the Revenue Cycle Representative is responsible for activities leading up to the initial electronic claims submission to include charge entry edits, payment posting, and overall account resolution of patient accounts by interacting with patients and insurance payors.  This position ensures timely submission of electronic claims, daily resolution of clearinghouse rejections and will assist in monitoring and resolving outstanding balances including unpaid, partial paid, underpaid, and overpaid claims for insurance and patient balances using aging reports, work queues and goal settings.

Essential Functions

  • Resolving pre-bill claim edits and ensure claims are clean and submitted daily
  • Reviewing daily clearinghouse rejections, resolving, and resubmitting accounts
  • Posting all insurance and patient payments received through automated and manual channels
  • Review aged accounts and take steps to resolve for payment by contacting payors for claim status, process rebilling requests and escalating issues when needed
  • Reviews denied claims to resolve by resubmitting corrected claims or filing claim reconsiderations
  • Reconciling all insurance and patient credit balances/overpayments and ensuring a timely refund is processed
  • First to receive and address all channels of patient billing inquiries and escalate as appropriate
  • Collect patient co-pays/coinsurance/deductible amounts due after insurance
  • Establish, monitor, and pursue patients with payment plans until reconciliation
  • Mail and correspondence management along with other department administrative functions
  • Perform various clerical activities to support daily operations
  • Creates and promotes a culture of continuous improvement
  • Ensures compliance with all CHN and affiliate policies, as well as all state and federal regulations
  • Demonstrates a commitment to CHN and Planned Parenthood’s mission related to health equity, especially centering racial equity, and deep sense of accountability to community
  • Demonstrates a commitment to learning about and enhancing practices related to racial equity and the impact of structural racism on healthcare systems
  • Provides positive and development feedback and accountability related to practices including, but not limited to, equity

The above duties and responsibilities are not an exhaustive list of required responsibilities, duties, and skills. Other duties may be added, and this job description can be amended at anytime.

Qualifications and Experience (Required)

  • 1 to 2 years of relevant account receivable experience
  • Previous experience using ICD-10 Medical Coding and Current Procedural Terminology (CPT)
  • Knowledge of medical terminology
  • Strong analytical and problem-solving abilities
  • Proficiency with Microsoft software (Excel, etc.)
  • Demonstrated ability to maintain a customer-centric service approach in a fast-paced environment
  • Excellent written and verbal communication skills and ability to collaborate and interact with all levels within and outside of CHN if necessary
  • Strong attention to detail and follow-up; and ability to multi-task in fast-paced environment
  • Demonstrated dedication to Planned Parenthood’s mission, vision, and values
  • Strong interpersonal skills and the ability to build relationships with stakeholders
  • Excellent time management, and problem-solving skills

Qualifications and Experience (Preferred)

  • Strong General Technology Skills: proficient utilization of Excel, Word, and Windows environment, Epic, eCW, NextGen or other practice management systems experience a plus
  • Medical Billing and Coding certification, a plus

Key Requirements

Other Jobs You May Be Interested In

  • Commitment to advancing race (+) equity in one’s work: interested in expanding knowledge about the role that racial inequity plays in our society
  • Awareness of multiple group identities and their dynamics, bringing a high level of self-awareness about personal identity, empathy, and humility to interpersonal interactions
  • Demonstrated ability to communicate clearly and directly as well as hear and act on feedback related to identity and equity with the aim to learn
  • Strong sense of accountability to equitable practices
  • Understanding of the impact of identity dynamics on organizational culture
  • Commitment to CHN and Planned Parenthood’s In This Together service ethos, workplace values, and service standards

Total Rewards. CHN provides employees with a competitive compensation and benefits; some highlights include the following.

  • Above Position Compensation Range: $18.00/hour (Minimum); goes up based on relevant experience
  • Geographic Differentials available for residences of NYC (Manhattan & Boroughs)
  • Health Care Coverage (Medical, Dental, & Vision); eligibility for full-time, regular employees on date of hire
  • Flexible Spending Accounts and Health Savings Account
  • Short-Term Disability and Basic Life & AD&D Insurance provided by CHN
  • Voluntary elections for Long Term Disability and Additional Life & AD&D Insurance available at cost
  • Employee Assistance Program
  • Retirement Plan, 3% employer match after one year of service
  • Paid Time Off Program includes accrual-based PTO and nine (9) paid Holidays

Clinical Health Network for Transformation (CHN)  is an equal employment opportunity employer. We comply with all applicable laws prohibiting discrimination based on race, color, religion, gender and gender expression/identity, age, ethnicity, national origin, ancestry, physical or mental disability, uniformed service member/veteran status, marital status, medical condition, pregnancy, sexual orientation, citizenship status, genetic information, as well as any other category protected by federal, state, or local. We are committed to building an inclusive workplace that values racial & social justice. We strongly encourage all persons to apply, including people of color and members of the LGBTQ community.

Revenue Cycle Representative Remote USA