Revenue Cycle Representative III

Piedmont Healthcare Inc.; Atlanta (GA); On-site; USD 60,000 - 85,000; Full time

Job summary

Piedmont Healthcare Corporate is seeking a Revenue Cycle Representative III to manage advanced physician billing responsibilities across the life cycle of patient accounts. The role emphasizes accuracy, customer service, and adherence to Piedmont values while maintaining productivity and audit quality above standard.

The Rep III performs core revenue cycle duties—billing, claims filing, data entry, insurance follow-up, denial management, and payment posting—with potential for advanced functions

Qualifications

• 5+ years in physician billing revenue cycle or Central Business Office.
• Advanced knowledge of third-party insurance plan types (HMO, PPO, POS, Indemnity).
• Strong knowledge of Medicare CPT/ICD9 coding and fraud regulations.

Responsibilities

• Billing and claims filing.
• Data entry and charge entry.
• Insurance follow-up and self-pay follow-up.
• Denial management and payment posting.
• Refund management and credit balance management.
• Customer service advocacy and response to patient inquiries.

Skills

Advanced Revenue Cycle knowledge

Customer Service

Financial counseling

HIPAA compliance

CPT/ICD9 coding

Education

High School diploma or GED

Tools

Practice Management System

Microsoft Office

Job description

Responsibilities

RESPONSIBLE FOR: The Revenue Cycle Representative III (Rep III) is a multi-tasking advanced position that encompasses all key functions of the physician billing Revenue Cycle. The Rep III position requires an advanced revenue cycle knowledge that has been acquired through experience and developed through training and education. The Rep III supports patient-centered care and Customer Service by serving as a patient advocate during the life cycle of the account. The Rep III is expected to maintain productivity above the average standard identified by the Revenue Cycle Department. Quality and accuracy of work performed by the Rep III is expected to be consistently above 90% when audited. Rep III performance will be measured according to the Piedmont Healthcare values of Compassion, Commitment, Service, Excellence and Balance and expected to be tiered in the top 1/3 in the department. Rep III Revenue Cycle duties may include but are not limited to Core Functions: Billing, Claims Filing, Data Entry, Charge Entry, Insurance Follow-Up, Self-Pay Follow-Up, Denial Management, Payment Posting, Refund Management, Credit Balance Management, Account Correction and Adjustment, Response to Patient Account Inquiries, Customer Service Advocacy, Self-Pay Collections, and Unapplied Cash, as well as, Advanced Functions; File Maintenance, System Support, Claims Edit Management, Claims Rejection Management, Front End Management, and Payment Variance Management. The Rep III Employee will be proficient in one or more advanced Revenue Cycle responsibilities or functions. Advanced Revenue Cycle responsibilities and functions are those above and beyond that of Core Revenue Cycle functions

Qualifications

MINIMUM EDUCATION REQUIRED:High School graduate or GED.

MINIMUM EXPERIENCE REQUIRED:Requires a minimum of 5(five) years of experience exhibiting advanced performance in a physician billing revenue cycle or Central Business Office.

MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:None

ADDITIONAL QUALIFICATIONS:Advanced knowledge of third-party insurance in regards to plan types: HMO, PPO, POS, and Indemnity. Excellent knowledge of the Medicare Program particularly as it relates to CPT and ICD9 coding CPT. Thorough knowledge of Medicare Fraud and Abuse regulations. Ability to counsel patients financially regarding outstanding charges and effectively resolve problems via the highest customer service skills and etiquette. Possesses advanced knowledge of the Practice Management System. Possesses the ability to run standard reports in order to answer questions from practice manager and physicians. Possess thorough knowledge of HIPAA regulations. This job requires proficiency with the computer systems that are used in the practice including Practice Management System, Internet products that relate to office functions and Microsoft office systems available to the office.

Business Unit : Company Name

Piedmont Healthcare Corporate