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Revenue Cycle Representative
Ohio State University Physicians. Review, verify, obtain, and correct patient demographics and insurance information .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing processes, including claims management, insurance verification, and patient account reconciliation. Proficient in analyzing denials and optimizing reimbursement through effective communication and problem-solving.
Highest-signal resume keywords
Medical Billing ExperienceClaims ManagementInsurance VerificationEPIC Software ProficiencyProblem-Solving Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ProcessingInsurance BillingPatient Demographics ManagementEOB AnalysisAccount ReconciliationRevenue Cycle ManagementMedical TerminologyDenial ResolutionInvoice ManagementRegulatory Compliance
Soft Skills
Organizational SkillsEffective CommunicationTime ManagementInterpersonal SkillsAbility to Manage Multiple Priorities
Tools & Technologies
EPICClearinghouse VendorsImaging Software Systems
Industry Keywords
Insurance Carrier Payment PoliciesAccounts ReceivableClaims DenialsPatient Information ManagementHealthcare Compliance
About the role
Key responsibilities & impact- Review, verify, obtain, and correct patient demographics and insurance information
- Process information related to medical diagnoses, laboratory and diagnostic services, hospital services, dates, authorizations, certifications, signatures, and insurance-bill preparation
- Resolve payer 277 rejections and denials and follow up on related issues
- Coordinate and analyze EOBs for denials and irregularities, take appropriate action, and reprocess claims
- Investigate and resolve unpaid claims to maximize reimbursement
- Research and resolve missing or conflicting patient information
- Request additional forms or information for denied claims or special processing requirements
- Update work queues and invoices for collection activity
- Reconcile accounts and adjust balances for denials, adjustments, payments, and other modifications
- Identify revenue-impacting trends and communicate issues to management
- Participate in analyses and solutions to reduce and resolve denials
- Follow up on accounts receivable research projects and provide status updates to the manager
- Act as a liaison between physicians, insurance companies, and third parties
- Perform other duties or special projects as assigned
Requirements
What you’ll need- High School diploma or equivalent with two or more years of medical billing experience; or equivalent combination of education and experience
- Knowledge of insurance carrier payment policies, practices and amounts
- Organizational and problem-solving skills
- Ability to manage multiple priorities
- Effective verbal and written communication skills
- Ability to work under time pressures or demanding requests
- Ability to interact and communicate with individuals at all levels of the organization
- Experience with EPIC, Clearinghouse Vendors and Imaging software systems preferred
- Knowledge of invoices, claims, insurance billing, collections, and medical terminology
- Ability to follow governmental regulations and company policies and procedures
Benefits
Comp & perks- Medical, dental, and vision benefits
- Health reimbursement accounts
- Flexible spending accounts
- Retirement benefits
- Employee assistance program
- Paid time off
- Paid holidays
- Wellness program
- Flexible, competitive benefit package