RCM Billing Representative (Circulogene)

Job Summary:
The RCM Billing Representative role ensures that the highest levels of RCM service delivery possible are
met and maintained. As part of that effort the RCM Billing Representative will be responsible for a variety
of administrative and clerical tasks ensuring the accuracy and completeness of billing data resolving billing
issues and maintaining accurate records.

The ideal candidate will have a strong attention to detail excellent organizational and communication
skills and the ability to work independently and as part of a team.

Essential Duties and Responsibilities:
ï Handle inbound phone calls regarding billing inquiries and patient responsibility.
ï All Mail Handling Responsibilities including but not limited to:
o Sorts and organizes all mail/or Faxes associated with Medical Record Requests Claims
Correspondence or any other insurance information including the uploading of the
information to the appropriate location and the notification to the associating team.
o Filtering all mail associated with the Billing Department.
o Logging of commercial payments and patient payments - informing the payment posting
team so reconciliation of payments can be done in the PM System.
o Daily review of lockbox payments and correspondence
o Works with the Accounts Payable department on Client Bill invoices and reconciliation of
payments.
ï Communicate with patients and healthcare providers to clarify or obtain necessary
information for billing.
ï Support and contribute to ad hoc special projects as needed
ï Verification of patient information including demographics eligibility and benefits.
ï Follow up with insurance companies or healthcare providers to ensure timely approval or
processing of prior authorization.
ï Oversee all outstanding patient AR and resolve patient billing discrepancies.

Required Qualifications/Skills:
ï Basic knowledge of Revenue Cycle Management within either Billing AR and Remittance
Posting.
ï Minimum 2 years of administrative experience
ï Ability to organize prioritize and manage various work assignments in a timely fashion
ï Knowledge of insurance carriers payment regulations including various reimbursement
schemes coinsurance and deductibles and contractual adjustments
ï Ability to review data identify issues and trends and propose recommendations on
necessary changes to management offshore team and team members.
ï Proficient in Microsoft Office 365.
Preferred Qualifications / Skills:
ï Knowledge of ICD-10-CM CPT and HCPCS codes.
ï Customer relations and/or hospitality experience is a plus.
ï Understanding of HIPAA regulations and confidentiality requirements.
ï Knowledge of Telcor is a plus

Education Requirements:
ï Minimum three (3) years of experience in Laboratory Physician or Hospital Billing AR
Follow-up and Remittance.
ï High School Diploma

Required Experience:

Unclear Seniority