Revenue Cycle Representative

Overview :

Resolv Healthcare is seeking a Patient Account Representative to join our dynamic team. As a Patient Account Representative, you will monitor assigned patient accounts for accurate and timely payment of claims by managing work queue, aging lists, and claims correspondence; reviews claim denials for problem areas; resubmits claims and files appeals as necessary.

Job Description :

• Manages work queue, aging lists, and claims correspondence to assure accurate and timely payment of accounts.
• Verifies completeness and accuracy of billing data and revises any errors.
• Reads and interprets denied claims in order to resolve discrepancies; resubmits or files appeal for reconsideration.
• Reviews aging accounts in order to collect amounts due or initiates escalation procedures for collections, according to established guidelines.
• Notes follow-up on billing records and maintains supporting documents and notes in established files; verifies that remittances meet contractual obligations.
• Audits and resolves discrepancies on patient accounts; reviews accounts for non-covered or out of network procedures and refers adjustments according to established guidelines.
• Receives telephone calls; answers inquiries and resolves patient account questions; contacts patients to obtain or relay account information.
• Requires regular and prompt attendance.
• Maintains and protects confidentiality in all aspects of patient health information, proprietary information, and employee information.
• Manages customer / client interactions in a professional manner; responds promptly to requests for service and assistance and meets those commitments.
• Demonstrates the spirit of the philosophy, mission, and values of IMD through words and actions, and implements them into department processes, programs, and the working environment.

Requirements :