Managing Revenue Cycle accounts receivable, following standard Operating Departmental Procedures to ensure prompt payment of payer and patient payments. Responsible for collaborating with other departments, or third parties, to drive payer and patient collections.
Revenue Cycle Functions:
Communicates directly with payers to follow up on outstanding claims and achieve timely reimbursement. This may include obtaining claim status, submitting reconsiderations, or submitting appeals.
Monitors and reviews denial reason codes to identify root causes; works with payer contracting, other areas of the revenue cycle, and payer representatives, if necessary to resolve issues
Analyzes data to track collection efforts, identify trends, and provide team with updates and ideas for improvement
Monitors payer files for accuracy, ensures payer documentation is completed by follow-up staff, and assists in updating files with pertinent information as necessary
Assists other follow-up staff in identifying high-risk accounts and prioritizing follow-up efforts
Helps to work and resolve accounts from other staff members’ workloads to prevent backlogs and fills in as needed for absent staff
Maintains superior understanding of claims management, third-party payer guidelines, state and federal regulations, and all other functions of the job; educates and trains other follow-up staff as needed
Maintains compliance with HIPAA guidelines and ensures staff maintain discrepancy when handling patient information
Works independently to resolve claims issues
Participates in continuous quality improvement efforts on an ongoing basis, establishing goals with supervisors and tracking progress
Offers suggestions to improve individual and team productivity
Maintains a quality review score of 90% or greater on department quality reviews
Assists supervisor with identifying departmental areas in need of improvements
Self-Development:
Attends 1 or more UC Health training and development courses per year
Other duties as assigned
Productivity:
Maintains 100% or greater each week on department productivity scoring and takes responsibility for individual productivity standards
Quality
Other duties as assigned
Education
Minimum Required: High School Diploma or GED. Preferred: Associate degree.
Experience
Minimum Required: 3 – 5 years of relevant experience in Revenue Cycle and/or Epic Revenue Cycle applications.
At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.
As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.
UC Health is an EEO employer.
Job details are sourced from the employer's original posting.
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UC Health is the University of Cincinnati's academic health system, providing advanced patient care and medical education.