Revenue Cycle Representative

Building Location:

Business Service Center

Department:

1006830 HOMECARE-HOSPICE CBO - EH SS

Job 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.

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:

FTE:

1

Possible Remote/Hybrid Option:

Remote

Shift Rotation:

Day Rotation (United States of America)

Shift Start Time:

Shift End Time:

Weekends:

Holidays:

No

Call Obligation:

No

Union:

Union Posting Deadline:

Compensation Range:

$19.28 - $28.92

Employee Benefits at Essentia Health: At Essentia Health, we're committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000.