Revenue Cycle Representative Remote USA ID-4824

December 26, 2024

The vision of Clinical Health Network for Transformation (CHN) is to better fulfill the mission and promise of Planned Parenthood to bring high-quality, affordable care to every member of our communities. CHN is a collaboration between Planned Parenthood affiliates across the United States.

CHN is looking for individuals who are committed to supporting our shared goal of strengthening and enhancing our awareness and commitment to advancing the cause of health and race equity in our organization.

Reporting directly to the Revenue Cycle Manager, the Revenue Cycle Representative is responsible for activities leading up to the initial electronic claims submission to include charge entry edits, payment posting, and overall account resolution of patient accounts by interacting with patients and insurance payors. This position ensures timely submission of electronic claims, daily resolution of clearinghouse rejections and will assist in monitoring and resolving outstanding balances including unpaid, partial paid, underpaid, and overpaid claims for insurance and patient balances using aging reports, work queues and goal settings.

Essential Functions

Resolving pre-bill claim edits and ensure claims are clean and submitted daily
Reviewing daily clearinghouse rejections, resolving, and resubmitting accounts
Posting all insurance and patient payments received through automated and manual channels
Review aged accounts and take steps to resolve for payment by contacting payors for claim status, process rebilling requests and escalating issues when needed
Reviews denied claims to resolve by resubmitting corrected claims or filing claim reconsiderations
Reconciling all insurance and patient credit balances/overpayments and ensuring a timely refund is processed
First to receive and address all channels of patient billing inquiries and escalate as appropriate
Collect patient co-pays/coinsurance/deductible amounts due after insurance
Establish, monitor, and pursue patients with payment plans until reconciliation
Mail and correspondence management along with other department administrative functions
Perform various clerical activities to support daily operations
Creates and promotes a culture of continuous improvement
Ensures compliance with all CHN and affiliate policies, as well as all state and federal regulations
Demonstrates a commitment to CHN and Planned Parenthood’s mission related to health equity, especially centering racial equity, and deep sense of accountability to community
Demonstrates a commitment to learning about and enhancing practices related to racial equity and the impact of structural racism on healthcare systems
Provides positive and development feedback and accountability related to practices including, but not limited to, equity

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The above duties and responsibilities are not an exhaustive list of required responsibilities, duties, and skills. Other duties may be added, and this job description can be amended at anytime.

Qualifications and Experience (Required)

1 to 2 years of relevant account receivable experience
Previous experience using ICD-10 Medical Coding and Current Procedural Terminology (CPT)
Knowledge of medical terminology
Strong analytical and problem-solving abilities
Proficiency with Microsoft software (Excel, etc.)
Demonstrated ability to maintain a customer-centric service approach in a fast-paced environment
Excellent written and verbal communication skills and ability to collaborate and interact with all levels within and outside of CHN if necessary
Strong attention to detail and follow-up; and ability to multi-task in fast-paced environment
Demonstrated dedication to Planned Parenthood’s mission, vision, and values
Strong interpersonal skills and the ability to build relationships with stakeholders
Excellent time management, and problem-solving skills

Qualifications and Experience (Preferred)

Strong General Technology Skills: proficient utilization of Excel, Word, and Windows environment, Epic, eCW, NextGen or other practice management systems experience a plus
Medical Billing and Coding certification, a plus

Key Requirements

Commitment to advancing race (+) equity in one’s work: interested in expanding knowledge about the role that racial inequity plays in our society
Awareness of multiple group identities and their dynamics, bringing a high level of self-awareness about personal identity, empathy, and humility to interpersonal interactions
Demonstrated ability to communicate clearly and directly as well as hear and act on feedback related to identity and equity with the aim to learn
Strong sense of accountability to equitable practices
Understanding of the impact of identity dynamics on organizational culture
Commitment to CHN and Planned Parenthood’s In This Together service ethos, workplace values, and service standards\