Revenue Cycle Representative (Work Comp) - Physician/Hospital Accounts Receivable Management (P[...]

Overview 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 the Workers Comp area 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 and 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. 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. Position Details Classification Title: Revenue Cycle Representative (Workers Comp) Schedule: Monday - Friday between the hours of 8:00 a.m. - 5:00 p.m. Percent of Time: 100% Pay Grade: 2B Location: Remote (in Iowa only) Hospital Support Services Building (HSSB) located in Coralville, IA Remote Work: Eligible to participate in remote work; remote eligibility evaluated after training; complying with remote work program and related policies. Position Responsibilities Resolve claims from an assigned work-queue to ensure all claims are worked within the timely filing/appeal guidelines. Determine if appropriate payment has been made by various entities; 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, resolve credit balances and outstanding accounts receivable by interacting with third-party entities via websites, telephone, or written inquiries. Identify and 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, coworkers and coordinators to resolve issues. Communicate changes in payer policies and denial trends; escalates claim payment delays as appropriate. Qualifications Education Required: Bachelor’s degree or equivalent combination of education and experience. Required Qualifications: Related customer service experience (typically 6 months or more) in a professional, financial, healthcare or medical related environment. Strong attention to detail with the ability to gather and analyze data and keep accurate records. Proficiency with computer software applications (Microsoft Office Suite or comparable programs) and the 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 HIPAA laws. Basic knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs. Applications and Equal Opportunity 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. 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. Support: Need help submitting an application or accepting an offer? Our Applicant Resource Center is available in the Fountain Lobby at the Main Hospital. Equal opportunity employer The University of Iowa is an equal opportunity employer. All qualified applicants are encouraged to apply and will receive consideration for employment free from discrimination on the basis of race, creed, color, religion, national origin, age, sex, pregnancy (including childbirth and related conditions), disability, genetic information, status as a U.S. veteran, service in the U.S. military, sexual orientation, or associational preferences. Persons with disabilities who need assistance or accommodations with the application or interview process may contact University Human Resources/Faculty and Staff Disability Services. For jobs in UI Health care, please contact UI Health care Leave & Disability Administration. #J-18808-Ljbffr