Revenue Cycle Representative
: Job Details :

Revenue Cycle Representative

Rochester, NY ( - Revenue Cycle

Job Type

Full-time

Description

Revenue Cycle RepresentativeAffiliate Wide - Buffalo, Rochester, Syracuse, NY

Planned Parenthood of Central and Western New York (PPCWNY) protects and provides health care and education that empowers individuals and families. With respect. Without judgment.No matter what.

Diversity and inclusion are core values and PPCWNY strives to recruit exceptional and diverse staff. PPCWNY strives to develop staff into leaders for a diverse and global workplace.

In support of Planned Parenthood of Central and Western New York (PPCWNY)'s mission, the Revenue Cycle Representative (RCR) has responsibility to ensure effective collections on all patient accounts and provides support to the Revenue Cycle Manager in assigned revenue cycle functions. In Collaboration with health center staff, Insurance Benefit Coordinators (IBCs) and Medical Billers, the RCR evaluates patient charges to identify active third-party insurance or eligibility to enroll in state sponsored insurance programs, monitors patient accounts and responds to patient account questions. This position has responsibility across four NYS affiliates through Shared Services; Planned Parenthood Central Western New York, Upper Hudson Planned Parenthood, Planned Parenthood of the Southern Finger Lakes, and Planned Parenthood of the North Country.

Essential Functions

+ Performs charge review of self pay encounters

+ Works in collaboration with Billing and IBC staff to identify potential to bill insurance or enroll in state sponsored insurance programs

+ Processes payments from patients and maintains accurate patient account records

+ Reconciles and posts the Phreesia and InstaMed self pay payment batches

+ Answers patient calls and addresses questions related to insurance and patient responsibility

+ Performs systematic, consistent, and timely collection follow up including phone calls and past due letters on accounts with outstanding balances according to patient collections policies and procedures

+ Establishes payment plans and follows up on patient accounts with established payment plans

+ Reviews patient statement reports for accuracy and prepares statements

+ Reviews unapplied payment reports and apply payments

+ Processes credit balances and donation request letters on a timely basis to ensure overpayments are addressed

+ Performs small balance write-offs and bad debt adjustments

+ Performs review of Lab Report, reconciles with PM, and submits to Finance for payment

+ Performs job duties in a confidential, ethical, and professional manner in adherence to corporate compliance standards as well as applicable regulations and laws

+ Works in collaboration with staff in other functional areas of the organization to successfully accomplish objectives and meet internal goals

+ Interprets and applies policies; identifies and recommends changes or workflow improvements

+ Notifies Revenue Cycle Manager of any collection or workflow issues

+ Assists with training of other staff

Customer Service

+ Builds and maintains positive, quality relationships with customers, both internal (colleagues) and external (patients, clients, donors etc.)

+ Acts in the best interests of the patient

+ Demonstrates commitment to exceeding customer expectations at every opportunity

+ Responds positively to customer concerns and demonstrates effective problem-solving skills

+ Shows respect to all internal and external customers for differences in backgrounds, lifestyles, viewpoints and needs in areas such as race, gender, ethnicity, creed, sexual orientation and others

Other Accountability Activities

+ Attends and participates in team meetings and other required meetings or training opportunities including education on insurance rules and regulations

+ Participates in affiliate initiatives

+ Participates in and adhere to agency's Compliance, Quality and Risk Management (CQRM) program

+ Performs other duties as assigned

Requirements

Applicants must possess the following qualifications (or equivalent combination of education and experience):

Education-

+ Associates degree in business, accounting, finance or a related field or equivalent combination of education and experience

Experience-

+ Minimum three years of experience in medical billing/collections

+ Minimum three years of experience with computerized billing/receivables system and reports; NextGen practice management experience preferred

Certifications-

+ Ideal candidate will have one of the following certifications but is not required: Registered Health Information Administrator (RHIA), Certified Health Information Technician (CHIT), Certified Coding Specialist (CCS), Certified Medical Billing Specialist (CMBS), or Certified Professional Coder (CPC)

Knowledge, Skills, & Abilities:

+ Experience with CPT, HCPCS and ICD-10 coding; ability to read and interpret medical procedures and terminology

+ Must be proficient in Microsoft Office (i.e., Excel, PowerPoint and Word)

+ Must be organized, able to prioritize tasks, and handle multiple projects effectively and prepare reliable, accurate documents within deadlines

+ Strong analytical and problem-solving skills; ability to read, interpret, analyze and apply information from various sources

+ Ability to communicate effectively, both orally and in writing

+ Work independently as well as collaboratively within a team environment

+ Must be sensitive to patient's financial and clinical needs while maintaining the patient's confidentiality

+ Planned Parenthood seeks candidates who have proficiency in one of the following languages, including but not limited to: Spanish, Nepali, Arabic, and Swahili

+ Planned Parenthood seeks candidates who have experience working with diverse racial and socio-economic populations, including African Americans, Hispanics or other racial and ethnic groups

+ A commitment to Planned Parenthood of Central and Western NY (PPCWNY)'s mission, vision and values along with a commitment to providing services to a diverse range of clients and to the goals of PPCWNY is essential

Physical Requirements

+ Possess sufficient mobility to perform the Essential Functions listed in this Job Description with or without an accommodation

+ Ability to travel to all agency locations as assigned

Work ScheduleThis is a full-time position; 40 hours per week, Monday-Friday

Benefits & CompensationAt PPCWNY, we are committed to equitable compensation practices and transparency. In alignment with these efforts, the pay for this position ranges from $18.05 to $20.89/hour. Actual compensation will be determined by experience and other factors permitted by law.

In addition to competitive compensation, PPCWNY offers an extensive benefits package with generous Paid Time Off, 10 paid holidays, affordable medical, dental, and vision options, Health Savings Account or Flexible Spending Account, 401(k) with match, and much more!

Planned Parenthood of Central and Western New York is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, protected veteran status, or status as a qualified individual with disability.

We are committed to workforce diversity and aspire to reflect the communities we serve. To that end, we strongly encourage people of color, LGBTQ identifying individuals, people with disabilities and other underrepresented groups to apply.

Salary Description

$18.05 to $20.89/hour