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Revenue Cycle Representative
Posted 30+ Days AgoFull Time
Essentia Health
Duluth, MN 55802Job Description:
The Revenue Cycle Representative administers the full cycle billing for the specialized areas of skilled nursing, home health or hospice. The Representative understands the overall workflow of the revenue cycle process and collaborates with clinical teams to ensure the services aligned with the billable charges, as well as ensure the proper documentation has been completed and submitted per payer guidelines. This position is responsible for improving Essentia Health’s current billing procedures and reducing A/R days. Responsibilities include accurate claim submission to payers, posting insurance and patient payments, working denials and resubmitting claims for maximum reimbursement, account corrections, self-pay and insurance collections, and follow up. This position will work on a number of tasks requiring in-depth evaluation and exercising judgement within the appropriate scope of practice and following appropriate guidelines. Experience in Home Health, Hospice or Skilled Nursing billing preferred.Education Qualifications:
Key Responsibilities:
- Completes insurance verifications and identifies terming approvals
- Monitors and tracks documentation, authorization renewals and benefits exhaustion
- Ensures the Common Working File is properly updated with services provided
- Reviews, corrects and updates claims based on edits to support accurate and compliant claims submissions
- Completes claim follow-up, denials, appeals and corrections
- Completes medical records requests by payers
- Completes daily, weekly and monthly reporting as assigned my leadership to ensure proper and compliant claims processing
- Pursues collections of unpaid self-pay/private pay balances
- Processes and submit monthly patient statements
- Perform self-pay/private-pay collections calls, send collections letters on past due accounts
- Collaborates with clinical staff to resolve complex billing issues
- Completes payment posting, correct posting errors, research credits and reconcile posting errors
- Provides support to the clinical team regarding payer questions, tools and resources, assisting with problem solving as needed
Required Qualifications:
- 2+ years of experience in healthcare billing, pre-services, accounting or financial analysis
Preferred Qualifications:
- Associate or bachelor’s degree in healthcare administration, finance, business administration, accounting or a related field preferred or commensurate professional experience
- 2+ years of healthcare revenue cycle experience
Licensure/Certification Qualifications:
No certification/licensure required.
Employee Benefits at Essentia Health*: Health Coverage: Medical, dental, vision, life and disability insurance, plus supplemental health benefit options to ensure employees' well-being.Retirement Savings Plans: 401(k) with employer contributions to support long-term financial security.Professional Development: Opportunities for career growth through training, tuition reimbursement, and educational programs.Work-Life Balance: Flexible scheduling, time off, holidays, and personal leave to help employees manage their professional and personal lives.Employee Wellness Programs: Initiatives focused on physical, mental, and emotional health, including fitness memberships, counseling services, and wellness activities.*Eligibility for Essentia Health’s benefit programs vary. Please refer to the benefit summary provided to you, or contact our HR Service Center at (218) 576-0000 for more information.
Job Location: Business Service Center
Shift Rotation: Day Rotation (United States of America)
Shift Start/End: 8:00/4:30
Hours Per Pay Period: 80
Compensation Range: $17.62 - $26.25 / hour
Union: DC USWA Main & Neighborhoods (DCUMN)
FTE: 1
Weekends: No