[Hiring] Revenue Cycle Representative (HB Reimbursement Verification) @University of Iowa

Role Description

University of Iowa Health Care’s department of Patient Financial Services is seeking a Revenue Cycle Representative for the Physician Hospital Accounts Receivable Management (PHARM) who will work as a resource for complex billing issues. The position aligns with our Hospital Billing Reimbursement Verification as part of the financial and insurance related team in the healthcare financial services industry. The Revenue Cycle Representative assists with a retrospective analysis of all claims/billing activities as it relates to PFS (Patient Financial Services) functions; including but not limited to:

• Registration
• Coding
• Billing
• Payment posting
• Credits
• Self-pay billing
• Denials
• In-depth contractual compliance analysis

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 Zoom from the HSSB building at a length determined by the supervisor. Remote eligibility will be evaluated upon a satisfactory job training opportunity.

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.
• 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.

Qualifications

• Bachelor’s degree or equivalent combination of education and experience.
• 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.

Desirable Qualifications

• 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.

Equipment

• Onsite: The department will provide a workstation which contains 3 (three) monitors, laptop/power cord, docking station/power cord, keyboard, mouse, headset, and desk supplies.
• Hybrid: While working onsite, the department will provide a workstation which contains 3 (three) monitors, a laptop/power cord, docking station/power cord, keyboard, mouse, headset, and desk supplies. When working offsite, the employee will take their laptop/power cord to carry back and forth, a second docking station/power cord to keep offsite. Prior to working offsite, the employee, at their own expense, will need to supply 2 (two) monitors, in addition to the university-issued laptop, which will serve as a third monitor due to its built-in camera function, a keyboard, and a mouse.
• Remote: When working offsite, the department will provide the employee a laptop/power cord, docking station/power cord, headset. Prior to working offsite and at their own expense, the employee will be required to obtain or possess 2 (two) monitors, in addition to the university-issued laptop, which will serve as a third monitor due to its built-in camera function, a keyboard, and a mouse.

Application Process

In order to be considered for an interview, applicants must upload the following documents and mark them as a “Relevant File” for the submission:

• Resume
• (optional) Cover Letter

Job openings are posted for a minimum of 7 calendar days and may be removed from posting and filled any time after the original posting period has ended. Applications will be accepted until 11:59 PM on the date of closing.

Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and credential/education verification. Up to 5 professional references will be requested at a later step in the recruitment process.

For additional questions, please contact Zach Schmidt at [email protected] .