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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates advanced knowledge of revenue cycle processes, including payment posting, billing, and follow-up, while ensuring compliance with Medicaid and Medicare regulations. Proficient in navigating payer claim portals and interpreting payer contracts to optimize account management.
Highest-signal resume keywords
Revenue Cycle ManagementPayment PostingMedicaid And Medicare Billing RegulationsPayer Contract InterpretationEffective Communication
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Payment HandlingCoordination Of BenefitsReading EOBMedical TerminologyComputer Literacy
Soft Skills
Customer ServiceMentoringProblem Solving
Tools & Technologies
Payer Claim PortalsOffice EquipmentSoftware Applications
Certifications & Qualifications
High School Diploma Or GED
Industry Keywords
HIPAA RegulationsInsurance Related ActivitiesPayer Behavior TrendsAccounts ResolutionFollow-Up Procedures
About the role
Key responsibilities & impact- Provide extraordinary, friendly, courteous, and professional service to customers
- Identify appropriate payment details and save backup documentation as appropriate
- Research, validate, and adjust payment postings
- Follow up according to procedures and policies to resolve accounts
- Use resources to find payment documentation and interpret payer contracts to ensure account codes match contracts
- Initiate payer recoupments, payer refunds, and patient refunds where applicable
- Navigate payer claim portals and understand payer functionality
- Communicate effectively orally and in writing
- Operate computers, office equipment, and software
- Train new and existing associates
- Identify payment, payer behavior, system, and workflow trends and escalate issues timely
- Assist leadership with mentoring peers and new hires
Requirements
What you’ll need- High School Diploma or equivalent (GED) required
- One (1) year of experience in hospital or physician back-end revenue cycle (Payment Posting, Billing, Follow-Up) required
- Knowledge of Medicaid and Medicare billing regulations required
- Two (2) years of experience in hospital or physician insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections) preferred
- Advanced knowledge of revenue cycle and health insurance payers
- Reading and understanding payer contracts
- Advanced knowledge of Coordination of Benefits
- Advanced knowledge of reading EOB
- Advanced knowledge of medical terminology
- Knowledge of payment handling
- Knowledge of HIPAA regulations
- Computer literacy and ability to operate computers, office equipment, and software
- Effective written and verbal communication
- Ability to read computer monitors and documents in English
- Ability to navigate various payer claim portals and understand payer functionality
- Ability to recognize true overpayments from false credits
- Ability to identify trends in payer behavior, system, or workflow issues and escalate timely
- Ability to assist with mentoring peers and new hires
- Ability to remain sitting or standing for long periods and perform occasional lifting, bending, kneeling, and reaching
- Ability to comply with remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and company equipment
Benefits
Comp & perks- Flexible work options where approved and stated in the job posting
- Generous benefits package covering programs for wellness, health, security, connection, and engagement
- Company equipment and remote work support referenced in remote work expectations