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Revenue Cycle Representative
Ohio State University Physicians. Process and verify invoices and insurance claims .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing processes, including claims processing, denials management, and insurance reimbursement analysis. Proficient in utilizing tools like EPIC and managing patient information to ensure compliance with regulations and maximize revenue.
Highest-signal resume keywords
Medical Billing ExperienceDenials And Appeals ManagementInsurance Carrier Payment PoliciesEffective Communication SkillsOrganizational And Problem-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 ProcessingInvoice VerificationRevenue Cycle ManagementPatient Demographics ReviewEOB AnalysisAccount ReconciliationClaims ReprocessingAging-Claim IdentificationDenial ResolutionInsurance Information Correction
Soft Skills
Organizational SkillsProblem-Solving SkillsAbility To Manage Multiple PrioritiesEffective Verbal CommunicationEffective Written Communication
Tools & Technologies
EPICClearinghouse VendorsImaging Software Systems
Industry Keywords
Insurance ClaimsRevenue CyclePayer RejectionsGovernmental RegulationsOSUP Policies
About the role
Key responsibilities & impact- Process and verify invoices and insurance claims
- Ensure payment of claims and review insurance reimbursements
- Track claims throughout the revenue cycle and identify aging-claim problem areas
- Review, verify, obtain and correct patient demographics, insurance information, diagnoses, services, dates, authorizations, certifications and signatures
- Resolve payer 277 rejections and denials and follow up on 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 denial-reduction and resolution analysis
- Follow up on accounts-receivable research projects and provide status updates to the manager
- Follow governmental regulations and OSUP policies and procedures
- 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
- Must have denials and appeals 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
- Preferred: Experience with EPIC, Clearinghouse Vendors and Imaging software systems
Benefits
Comp & perks- Medical insurance
- Dental insurance
- Vision insurance
- Health reimbursement accounts
- Flexible spending accounts
- Retirement benefits
- Employee assistance program
- Paid time off
- Holidays
- Wellness program