[Hiring] Revenue Cycle Representative (HB Follow-Up & Denials) @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 Insurance Follow Up and Denials 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. Remote work must be performed at an offsite location within the State of Iowa. 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.

Per policy, work arrangements will be reviewed annually and must comply with the remote work program and related policies and employee travel policy when working at a remote location.

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.

Requirements

• 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.
• Experience using Epic or another electronic health record (EHR) system.

Benefits

• Remote work eligibility within the state of Iowa.
• Training provided either onsite or via Zoom.
• Workstation provided by the department for onsite and hybrid work.

Company Description

University of Iowa Health Care—recognized as one of the best hospitals in the United States—is Iowa's only comprehensive academic medical center and a regional referral center. Each day more than 12,000 employees, students, and volunteers work together to provide safe, quality health care and excellent service for our patients. Simply stated, our mission is: Changing Medicine. Changing Lives.®

• WE CARE Core Values:
• Welcoming: Promotes the dignity of our patients, trainees, and employees.
• Excellence: Pursuit of quality and accessible health care, education, and research.
• Collaboration: Teamwork guided by compassion.
• Accountability: Ethical behavior and integrity.
• Respect: Creating a safe and valued environment.
• Empowerment: Fair access to research, health care, and education.

Position 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 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.
• Identify & report undesirable trends and reimbursement modeling errors or underlying causes of incorrect payment.
• 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 Coordinators to resolve issues.
• Communicate changes in payor policies and denial trends; escalates claim payment delays as appropriate.