Revenue Cycle Representative at Careerbuilder

Posted in Education 26 days ago.

Location: Iowa City, Iowa





Job Description:
Classification Title: Revenue Cycle Representative (PVC1)

Department: College of Dentistry - Dental Patient Business Office

Staff Type: P&S

Type of Position: Regular

Pay Grade: 2B

Salary: $35,624 to commensurate

Percent Time: 100%

Schedule: Monday - Friday, 8:00am - 5:00pm;

May require occasional overtime.




Location: Iowa City, IA

Job Duties:
Acts as College of Dentistry Patient Business Office Financial Counselor. Provides financial counseling, collects cash and establishes payment arrangements for the College of Dentistry. Duties include: collects, verifies and registers insurance information into patient accounting system (PAS); submits pre-authorizations to insurance carriers for planned treatment and disseminates results to providers/staff; orients and educates providers and staff re: College of Dentistry and payer specific billing requirements; participates in educational presentations to faculty and students; communicates with providers and clinic administration staff re: discrepancies in billing. Environment - position functions in an open-office environment which may be in close proximity with co-workers.

Patient Revenue Management

  • Informs patient of College of Dentistry financial policies.
  • Obtains patient signature on Patient Treatment Consent/Financial Agreement.
  • Collects patient identification and records appropriately into AxiUm.
  • Obtains new or updated insurance information and adds to the PAS. Verifies insurance via insurance websites, phone calls or verification software.
  • Provides Financial Counseling to patients obtains insurance benefit, informs patient of non-covered services, calculates estimated patient out-of-pocket responsibility. Informs provider and patient of expected insurance benefit and out-of-pocket responsibility: collaborates with provider to develop a treatment plan within the patient's financial parameters.
  • Submits pre-authorizations to insurance with required chart documentation. Coordinates results of pre-authorization with provider/clinic to ensure future patient treatment is financially secured.
  • Provides Active Military patients with required Readiness form; coordinates with provider for treatment plan completion.
  • Establishes patient payment plan(s) in compliance with College of Dentistry guidelines. Obtains patient signature on payment plan contract.
  • Documents all communications relative to the patient's treatment/financial status in the PAS. Posts personal and/or insurance payments according to established guidelines.
  • Serves as an expert resource (for staff, providers and patients) re: Title 19 and Dental Wellness coverage guidelines.
  • Coordinates patient concerns re: charges with appropriate clinic personnel and/or Patient Representative.
  • Rebills corrected charge to insurance when applicable. Initiates patient or insurance refunds as appropriate and applicable.
  • Is an active participant in the business office Automated Call Distribution (ACD) system to address and resolve incoming patient and insurance carrier inquiries. May be called upon to participate in student orientation and/or educational forums.
  • May be called upon to submit medical or dental claims to insurance payors.
  • Posts insurance and/or patient payments to the PAS. Reconciles posted payments to daily deposit into the University of Iowa's General Ledger.


Operations and Performance Standards

  • Abides by HIPAA regulations; treats all information received as confidential.

  • Seeks appropriate written or verbal consent from the guarantor before releasing confidential information.

  • Follows University of Iowa and College of Dentistry cash handling regulations. Accounts for daily cash advance and safeguards same in secured cash box or bank bag. Follows unit protocol for audit and security purposes.

  • Logs in to receive incoming calls through ACD Phone system.
Reporting

  • Reviews Pre-Pay report to ensure posting to the applicable clinic.
  • Reviews out of balance payment plan report to ensure accurate billing of payment plans.
  • Processes patient refunds based on entries in patient credit report.


Communication/Training

  • Discusses charge posting concerns with Patient Managers and takes corrective billing action as needed.
  • Cross-trains with fellow team members to learn additional duties to provide support as needed.
  • Receives and places calls to insurance companies to discuss policy benefits and explanation of benefit (EOB) responses.
  • Participates in monthly team meetings; brings problems (as well as proposed solutions) to supervisor, management's attention.


Please attach a resume, cover letter, and 3 names of professional reference as part of the application process. Job openings are posted for a minimum of 14 calendar days. This job may be removed from posting and filled any time after the minimum posting period has ended.

Education or Equivalency Required:
Bachelor's degree or equivalent combination of education and relevant experience.

REQUIRED Qualifications:

1-3 years relevant experience in a medical/dental business office with financial counseling, cash collection, knowledge of insurance claim processing requirements/adjudication experience and strong customer service skills including the following skillsets:



  • KNOWLEDGE OF HEALTH AND/OR DENTAL CARE REIMBURSEMENT - Basic Experience


Knowledge of the full spectrum of activities, practices, tools, and considerations for managing health and/or dental care reimbursement processes. Examples of relevant competencies the position would require are:

    • Can identify the major activities of the patient revenue management function and explain to customer/patient.
    • Understands basic principles, techniques and terminology of claims processing and reimbursement.
    • Can identify major types of coverage, associated claims and payment processes.
    • Is aware of the payer's claim settlement practices.




  • KNOWLEDGE OF HEALTH AND/OR DENTAL CLAIMS - Basic Experience


Knowledge of the full spectrum of activities, practices, tools, and considerations for managing claims processing. Examples of relevant competencies the position would require are:

    • Can identify the major activities of the claims function.
    • Understands basic principles, techniques and terminology of dental and medical claims processing.
    • Can identify major types of coverage and associated claims.
    • Is aware of the company's claim settlement philosophy.


  • HIPAA - Knowledge and understanding of the Health Insurance Portability and Accountability Act - Working Experience


Knowledge and understanding of the Health Insurance Portability and Accountability Act. Examples of relevant competencies the position would require are:

    • Describes the implications of the law to own function.
    • Participates in implementing adherence to specific aspect of this law.
    • Describes major HIPAA-related challenges to the organization.
    • Identifies relevant procedures that demonstrate HIPAA adherence.
    • Describes types of plan conversions in compliance with HIPAA guidelines.


HIGHLY Desirable:

  • Experience with electronic health record/patient accounting system.
  • Experience in a dental practice.


Note to Applicant: Applicants should assure their application/resume and cover letter illustrate the work experience they have that demonstrates the qualifications and competencies listed above. Unless otherwise noted, the proficiency level required for this position is Basic or Working Experience.

  • Basic Experience is defined as uses basic understanding of the field to perform job duties; may need some guidance on job duties; applies learning to recommend options to address unusual situations.
  • Working Experience is defined as successfully completes diverse tasks of the job; applies and enhances knowledge and skill in both usual and unusual issues; needs minimal guidance in addressing unusual situations.


Definitions of the other proficiency levels are found at: http://www.uiowa.edu/hr/classcomp/prof/competencies.html .

The Revenue Cycle Representative is the 1 st of 5 levels in the Revenue Cycle (PVC) job family. For more information about this job family visit: https://hris.uiowa.edu/CC_Redesign/driver.php?ACTION=DETAIL&FAMILY=PVC .