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Revenue Cycle Representative - Hospital Dentistry at University of Iowa

Posted in Other 30+ days ago.

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Location: Iowa City, Iowa

Job Description:
Job Duties:
Make adjustments to and verify charges to patient accounts in the Hospital Dentistry Institute. To assimilate and analyze medical/dental benefit data to the resolution of a patient's account; disseminate this information to insurance carriers, 3 rd party agencies, the patient, staff and faculty. Prepare and submit pre-authorization on the patient's behalf to their insurance carriers. Analyze and explain results of pre-authorization to the patient. Collect money, apply to patient account and prepare deposits of revenue. Manage Account receivables to maximize revenue and minimize outstanding patient balances to include entering/updating patient information and monitoring reimbursement outcomes. Serve as a resource person to effectively communicate with patients/families and provide financial counseling.

Patient Revenue Management

  • Compile and enter data to billing system to submit claims to carriers and/or generate patient statement, ensuring accuracy and compliance.
  • Maintain up to date insurance registration and rank appropriately for maximizing reimbursement.
  • Advise patients of financial policies; work with collection agency to facilitate payment; provide financial counseling to patients and/or families.
  • Advise patients of financial policies; work with collection agency to facilitate payment; provide financial counseling to patients and/or families.
  • Verify eligibility of benefits, patient liability, non-covered exceptions; confirm all steps necessary have been taken to adjudicate claims and billing while providing outstanding customer service.
  • Submit claims after verifying coding, modifiers if appropriate.
  • Post self-pay and insurance payments; initiate patient and insurance refunds and overpayments.
  • Resolve patient billing account concerns in order to obtain appropriate reimbursement and patient satisfaction in partnership with management and clinical teams.
  • Establish payment arrangements, counsel and coordinate available financial assistance with patient as necessary.

Operations and Performance Standards

  • Note discrepancies in payment, changes in coding practices and/or payments to identify unfavorable trends.
  • Proactively participate in processes to ensure hospital and dental billings are coordinated accurately.
  • Attend internal, local, regional and possible national meetings to maintain a thorough and competent knowledge of business operations and maintain/improve technical and professional skills.
  • Review accounts to insure UCR, non-allowable is computed correctly or appropriate adjustments are made
  • Analyze trends in payments and denials, reporting to superviosr
  • Review delinquent balance report, analyze accounts, prepare documentation to meet required timeframe for appropriate collection status and accurate statement generation.


  • Analyze and interpret outstanding claims reports; follow-up with appropriate action to minimize outstanding balances.
  • Utilize reports to review financial status of upcoming appointments, identify payment plan opportunities, pre-approvals, and required payment prior to service.
  • Review monthly Account Receivables report by provider to identify any difficulties with personal payment and insurance issues.


  • Assist in the development of and participate in orientation and training for residents, faculty and staff re: filing procedures, coding changes, documentation requirements.
  • Demonstrate thorough understanding of policy regulations and coverage to educate patient population as needed.
  • Demonstrate HIPPA compliance and patient rights' provide outstanding customer service by mail and in person.
  • Demonstrates understanding of the patient's treatment plan, corresponding charges, and insurance status to respond to questions/concerns and provide financial counseling.
  • Interface with staff, patients, and families by maintaining current, thorough, and accurate notes regarding financial/treatment status.

Please attach a cover letter, resume, and 3 names of professional reference as part of the application process. Job opening 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. For questions or additional information, please contact .

Successful candidates will be subject to a criminal background check.


  • Bachelor's Degree in Business Administration, Accounting, Health Administration or equivalent, or equivalent combination of education and relevant experience.
  • 6 months to one year directly related experience which includes a full spectrum of activities managing claims processing in a medical/dental practice to include:
    • Data Gathering and Reporting - Basic Experience
Knowledge of and ability to utilize tools, techniques and processes for gathering and reporting data in a particular department or division of a company.
      • Identifies the key objectives of gathering data.
      • Identifies key sources of needed information.
    • Effective Communications - Basic Experience
Understanding of effective communication concepts, tools and techniques; ability to effectively transmit, receive, and accurately interpret ideas, information, and needs through the application of appropriate communication behaviors.
      • Speaks/writes using correct language, mechanics, and gestures.
Knowledge of the full spectrum of activities, practices, tools, and considerations for managing claims processing to include:
      • Can identify the major activities of the patient revenue management function.
        • Patient financial counseling
        • Third party pre-authorization
        • Establishing payment plans
        • Receiving co-pays
        • Managing delinquencies and collection process.
      • Understands basic principles, techniques and terminology of claims processing are reimbursement.
        • Claims submission including CPT/CDT codes.


Knowledge of the major responsibilities, accountabilities, and overall organization of the customer support function or department; ability to properly support customer inquiries and bring problems to a timely resolution.

  • Clarifies the role and contribution of the customer support function.
  • Describes major tasks and responsibilities of a customer support function.
  • Experience with electronic health record and electronic claims submission, ideally w/AxiUm and/or Epic.

Applicable materials should clearly indicate qualifications for advertised position.

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 the position is Basic Experience 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: .

The Revenue Cycle Representative is the 1 st of 7 levels in the Revenue Cycle (PVC) job family. For more information about this job family visit: .