The Revenue Cycle Representative I is directly responsible for securing all scheduled and unscheduled patient appointments: including insurance benefit verification, obtaining financial demographics, financial classification assignment and submitting clean claims for charge entry including reconciling against CROWN and GE/IDX TES reports.
Responsible for securing account by verifying insurance eligibility using available systems such as Experian, Eagle and Web-based payer eligibility tools.
Contacts patient if necessary to complete registration, collect defined minimum data set, including patient demographic and other identification data, insurance or other third-party payer information.
Documents and updates all registration and financial data in the GE/IDX system. Responsible for the correct identification and selection of appropriate insurance FSCs and reviews entire account for continuity.
Notifies practice of patient financial liability and obligation
Reviews and submits clean electronic (CROWN) and paper encounters.
Reconciles and corrects encounters by using CROWN pending report and clinical desktop.
Reconciles and corrects GE/IDX TES reports using billing and coding knowledge.
Minimum of one-year experience in a physician billing or third party payor environment. Proficiency in health insurance benefits and eligibility requirements.
GE/IDX experience or comparable professional billing system.
Knowledge of insurance plans and all lines of business, insurance billing requirements, worker’s compensation, Medicare and Medicaid.
Good interpersonal, verbal, telephone and written communication skills in the English language.
Functional knowledge of basic computer operation and keyboard functions.
High school graduate or GED certificate.
Ability to follow-through and handle multiple tasks simultaneously.
Ability to work independently.
Must be a motivated individual with a positive attitude and exceptional work ethic.
Experience with Electronic Medical Record, preferably Allscripts software preferred.
Other Computer Software Skills such as Eagle, Microsoft Work, Excel and Email preferred.