Revenue Cycle Analyst

Revenue Cycle Representative

University of Iowa Health Carerecognized as one of the best hospitals in the United Statesis 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.

The Revenue Cycle Representative (RCR) is an entry-level customer service and financial related position in the healthcare industry. The RCR will provide exceptional customer service to our external customers: patients, insurance contacts, etc; as well as internal customers. Support UI Health Care "Service Excellence" standards to all our customer groups, utilize tools and processes to make independent decisions and will maintain integrity and treat internal and external customers respectfully. The RCR will work in a high volume web-based application environment and be part of an incoming and outbound call environment.

Contact patients, insurance companies, pre-authorization, referrals, and to resolve patient account inquiries.

Ensure all patient appointments are financially secured by completing insurance notification if referral or preauthorization is required. Analyze and verify patient demographic, insurance eligibility and financial information/responsibility for accurate claim submission and reimbursement.

Provide financial counseling to patients and families; and/or determine if appropriate payment has been made by various entities; and/or work with patients and insurance companies to obtain correct payments; and/or appeal claim payments and/or denials.

Identify & report trends and reimbursement modeling errors and/or underlying causes of incorrect payment; review allowed variances from third party payers.

Be expected to 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 supervisor to resolve issues.

Work with PFS and payors to provide time sensitive documents and ensure that deadline dates are met and that UI Health Care is in compliance.

Maintain extensive working knowledge and expertise based around payer regulations/policies, financial classifications.

Build and maintain solid working relationships with clinical staff, referral sources, insurance companies, medical providers and public.

Work Epic-work queues related to referrals/pre-authorizations, and any associated denials and requested documentation.

Education Requirements:

A Bachelor of Science degree or an equivalent combination of education and experience.

Experience Requirements:

Related customer service experience (typically 6 months or more) in a professional, financial, health care or medical related environment.

Strong attention to detail and 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.

Ability to demonstrate the core competencies and commitments for the organization which includes striving for performance excellence to include a "Basic" proficiency of the Universal Competencies.

Must have demonstrated ability to prioritize, multi-task & quickly change focus in fast-paced team environment.

Must have the ability to exhibit compassion and empathy when working directly with patients and/or their families.

Professional experience working effectively with individuals from a variety of backgrounds and perspectives.

Desired 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.