Revenue Cycle Representative

Overview:

Revenue Cycle Representative 

Capitol Park Mental Health Hospital is seeking a detail-oriented Revenue Cycle Representative to join our Business Office team. This role is responsible for managing insurance accounts receivable, following up on outstanding claims, resolving claim issues, and ensuring timely reimbursement from third-party payors. We are looking for someone who understands revenue cycle and the importance of evaluating and securing all appropriate reimbursements from insurance or patients.

This role is Monday-Friday 8a-4:30p. The pay for this role is $23-$28/hour depending on qualifications and years of experience.

Responsibilities:

Responsibilities 

• Follow up on outstanding insurance claims and resolve payment issues. 

• Review, correct, and resubmit denied or rejected claims. 

• Utilize claims clearinghouse systems to manage claim submissions and edits. 

• Review and interpret Explanation of Benefits (EOBs) to ensure claims are processed and paid correctly. 

• Complete account adjustments with supporting documentation. 

• Maintain productivity standards of 30-40 accounts worked per day. 

• Collaborate with Financial Counselors and Business Office leadership regarding reimbursement and eligibility concerns. 

Qualifications:

Qualifications 

• High school diploma or equivalent required. 

• Ability to read, understand, and analyze Explanation of Benefits (EOBs) and identify claim payment discrepancies. 
• Prior admissions and or collections experience in a hospital setting required.

• Strong attention to detail and problem-solving skills. 

• Psychiatric or behavioral health experience preferred. 
• Experience with Avality or Medhost preferred.

 

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.