Revenue Cycle Representative

Job Overview
We are looking for an ambitious Revenue Cycle Specialist to join our team and support our clients by managing end-to-end revenue cycle responsibilities. As a critical member of the team, you will ensure the accuracy, efficiency, and compliance of revenue cycle processes, from claims submission to denial management. This is a fantastic opportunity for an individual looking to grow with a rapidly expanding company.

Key Responsibilities

• Claims Submission & Follow-up
• • Submit claims and ensure follow-up on outstanding claims, ensuring timely resolutions.
  • Prioritize insurance aging reports to identify unpaid insurance claims and drive resolution via insurance portals and telephone communication.
• Denial Management
• • Manage and resolve denials efficiently, ensuring that claims are processed and resolved in a timely manner.
  • Submit appeals to insurance providers as needed, following proper procedures to ensure maximum reimbursement.
• Insurance Verification & Authorization
• • Collaborate with internal departments and external providers on utilization management of authorizations.
  • Ensure up-to-date documentation in billing software and verify insurance coverage.
• Transaction Posting & AR Follow-up
• • Post transactions and manage accounts receivable follow-up.
  • Work with insurance providers to resolve any discrepancies and ensure timely reimbursement.
• Credit Balance Accounts
• • Process credit balance accounts by generating refunds to appropriate parties or correcting adjustments as necessary.
• Compliance & Documentation
• • Ensure compliance with all federal, state, local, and internal policies and procedures.
  • Maintain accurate billing records and ensure that all processes comply with HIPAA privacy rules and confidentiality standards.
• Collaboration & Process Improvement
• • Report discrepancies, admission errors, and coding questions to appropriate departments for process improvement.
  • Support team initiatives and contribute to ongoing improvement efforts in revenue cycle processes.
• Customer Service & Communication
• • Provide excellent customer service to both internal and external customers, ensuring timely resolution of issues.
  • Effectively communicate orally and in writing, collaborating with teams and clients to address challenges.

Key Performance Indicators (KPIs)
Performance will be measured based on the following KPIs:

• Production: Consistent completion of tasks within expected timelines.
• Quality: Accuracy and adherence to guidelines in claims submission and follow-up.
• Resolution %: Rate of successful claim resolution, including denials and unpaid claims.

What We Offer

• Compensation: Competitive compensation package, commensurate with experience
• Medical, Dental & Vision Insurance: Comprehensive health plans for you and your family
• Life Insurance: Employee life insurance coverage
• Paid Time Off: Generous PTO for a balanced work-life experience
• 401(k) Plan: Company match to support your long-term financial goals
• Additional Benefits: Paid holidays, flexible scheduling options, and a collaborative work environment

Minimum Qualifications

• Experience: 2+ years of relevant experience in finance/healthcare, medical billing, and reimbursement.
• Systems Knowledge: Experience with State and Federal insurance (Medicare, Medicaid) and private insurance billing portals.
• Software Proficiency: Proficient in Microsoft Office (Word, Excel), Epic, Meditech, and Salesforce (a plus).
• Communication Skills: Ability to effectively communicate and work with both internal teams and external clients.
• Attention to Detail: Must have strong attention to detail for researching and interpretation of billing information.
• Customer Service: Demonstrated ability to provide excellent customer service to both internal and external customers.

Work Environment & Physical Requirements

• Location: Hybrid remote role based in Indianapolis, IN (46220)
• Schedule: Full-time, Monday to Friday
• Work Environment: The role will be performed primarily in an office setting with moderate noise levels. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Join Us
At HCM, you will play a vital role in optimizing the revenue cycle processes that support our clients and help them achieve financial efficiency. If you are detail-oriented, customer-focused, and eager to make an impact in a growing company, we invite you to apply today and join our team!

Healthcare Chaos Management (HCM) is a 40-year-old, nationally scaled healthcare revenue cycle company that is transforming into a cutting-edge Healthcare FinTech organization. We serve hospitals and healthcare systems across the U.S., blending human-centric service with intelligent automation to improve patient financial experiences and optimize healthcare revenue operations.