Revenue Cycle Rep II - Claim Edits

Piedmont Healthcare; Atlanta (GA); Remote; USD 40,000 - 55,000; Full time

Job summary

Piedmont Healthcare is seeking a Senior Business Office Representative to manage essential functions of the Central Business Office. This role involves handling patient account inquiries, insurance follow-up, and training within a remote work environment. Ideal candidates will possess strong knowledge of third-party insurance, HIPAA regulations, and effective financial counseling skills.

Qualifications

• Minimum two years related experience or equivalent education.
• Must handle functions of at least one unit in the Central Business Office for two years.

Responsibilities

• Handle Insurance Follow Up, Self-Pay Follow Up, Payment Posting.
• Answer Patient Account Inquiries and monitor billing errors.
• Provide training in Central Business Office duties.

Skills

Knowledge of third-party insurance plans

Knowledge of the Medicare Program

Knowledge of Medicare Fraud and Abuse regulations

Financial counseling skills

Knowledge of Next Gen Practice Management system

Knowledge of HIPAA regulations

Proficiency with Microsoft Office applications

Education

High School Diploma or GED

Job description

RESPONSIBLE FOR:

The Senior Business Office Representative is a multi-task position that covers all main functions of the Central Business Office. The Business Office Representative Two has demonstrated the ability to accurately handle at least one unit function of the Central Business Office for at least two years.

Responsibilities include, but are not limited to: Insurance Follow Up, Self-Pay Follow Up, Payment Posting, Account Correction and Adjustment, Answering Patient Account Inquiries, and Monitoring Billing Errors and claim/line item rejections.

This role provides initial training in all duties of the Central Business Office at an elementary level. The position is designed to develop the incumbent into a Business Office Representative Three after two additional years of acceptable performance. Before promotion to a Business Office Two, the candidate must be able to handle the complete functions of at least one Central Business Office Unit.

**REMOTE/WORK FROM HOME**

QUALIFICATIONS:

• MINIMUM EDUCATION REQUIRED: High School Diploma or GED.
• MINIMUM EXPERIENCE REQUIRED: Two (2) years related experience or an equivalent combination of education and experience.
• MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW: None
• ADDITIONAL QUALIFICATIONS:

• Moderate knowledge of third-party insurance plans such as HMO, PPO, POS, and Indemnity.
• Moderate knowledge of the Medicare Program, especially concerning CPT and ICD9 coding CPT.
• Thorough knowledge of Medicare Fraud and Abuse regulations.
• Ability to financially counsel patients regarding outstanding charges and resolve issues effectively while maintaining a positive public relations image.
• Moderate knowledge of Next Gen Practice Management system.
• Full knowledge of HIPAA regulations.
• Proficiency with computer systems used in the practice, including Practice Management System, Internet tools related to office functions, and Microsoft Office applications.