Job Description
Job Description:
The Revenue Cycle Representative performs the full billing cycle for Home Health agencies. The Representative understands the overall workflow of the revenue cycle process and collaborates with clinical teams to ensure the services align with billing, as well as ensure the proper documentation has been completed and submitted in accordance with payer guidelines. This position is responsible for following Essentia Health’s billing policies and procedures. Responsibilities include accurate claim submission to payers, working denials, phone calls to payers and clients, account corrections, insurance collections, and follow up. This position works on a variety of tasks requiring in-depth research into specific client accounts as well as specific payer requirements. Experience in Home Health billing and EPIC is preferred.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
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.
Job Location: Business Service Center
Shift Rotation: Day Rotation (United States of America)
Shift Start/End: Varies/Varies
Hours Per Pay Period: 80
Compensation Range: $18.15 - $27.04 / hour
Union: DC USWA Main & Neighborhoods (DCUMN)
FTE: 1
Weekends:
Call Obligations:
Sign On Bonus:
Job Details
Job Title
Revenue Cycle Representative
Position Type
Full Time
Requisition ID
R068839