University of Iowa Research · 3 days ago
Revenue Cycle Representative (VA Referrals) - Patient Access Management (PAM) - Patient Financial Services (PFS)
Iowa City, Iowa, United States
Full-time
Hybrid
New Grad, Entry Level
0+ years expUniversity of Iowa Health Care is seeking a Revenue Cycle Representative for an entry-level customer service and financial position within their Patient Financial Services department. The role involves providing exceptional customer service to patients and insurance contacts, verifying insurance coverage, and assisting with medical necessity documentation.
Research
Responsibilities
Review accounts, verify insurance coverage and initiate pre-certifications, pre-authorizations, referral forms and other requirements related to managed care; route to appropriate departments as needed
Assist in monitoring utilization services to assure cost effective use of medical resources through processing VA referrals and prior authorizations
Communicate with patients and/or referring physicians on non-covered benefits or exam coverage issues
Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
Ensure insurance carrier documentation requirements are met and authorization/referral documentation is scanned and recorded in the patient’s medical record
Appeal authorization denials and/or set-up peer to peer reviews
Collaborate with other departments to assist in obtaining authorizations in a cross-functional manner
Contact patients and insurance companies for payment acquisition, authorizations or to resolve patient account inquiries
Provide financial counseling to patients and families; determine if appropriate payment has been made by various entities; work with patients and insurance companies to obtain correct payments; appeal claim payments and/or denials
Collect demographic, insurance, and clinical information to ensure that all reimbursement requirements are met
Maintain an extensive working knowledge and expertise of insurance companies and billing authorization/referral requirements
Communicate with other referral/authorization specialists, patient account representatives and coders to continually monitor changes in the health insurance arena
Identify & report undesirable trends and reimbursement modeling errors or underlying causes of incorrect payment; review allowed variances from third party payers
Be expected to maintain a high-level of accuracy to meet productivity and quality requirements
Identify trends and/or work processes for potential process improvements
Review and analyze report data to provide status updates to leadership
Communicate with providers, payers, patients, internal departments, co-workers, and Coordinator’s to resolve issues
Maintain extensive working knowledge and expertise based around payer regulations/policies, financial classifications and financial assistance programs
Build and maintain solid working relationships with clinical staff, referral sources, insurance companies, medical providers and public
Qualification
Required
Bachelor's degree or equivalent combination of education and relevant experience
6 months or more of related customer service experience in a professional, financial or health care related environment
Knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs
Strong attention to detail and proven ability to gather and analyze data and keep accurate records
Proficiency with computer software applications, i.e. Microsoft Office Suite (Excel, Word, Outlook, PowerPoint) or comparable programs and an ability to quickly learn and apply new systems knowledge
Demonstrated ability to handle complex and ambiguous situations with minimal supervision
Self-motivated with initiative to seek out additional responsibilities, tasks, and projects
Effective communication skills (written and verbal), active listening skills and the ability to maintain professionalism while handling difficult situations with callers or customers
Successful history collaborating in a fast-paced team environment
Preferred
Experience handling difficult callers, customers, and patients
Experience and knowledge of Patient Financial Services' functions, systems, processes & policies
Familiarity with medical terminology
Knowledge of Health Insurance Portability and Accountability Act (HIPAA) laws
Experience identifying opportunities for improvement and making recommendations and suggestions
Experience with multiple technology platforms such as Epic, Cirius ACD, and/or GE
Ability to drive results and foster accountability throughout the team and organization
Company
University of Iowa Research
The Office of the Vice President for Research is committed to forging new frontiers of discovery by providing resources and support to researchers and innovators at the University of Iowa, to promote a culture of creativity that enriches the campus, the state, and the world.
1001-5000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase