Experienced Revenue Cycle Representative – Remote Opportunity in the USA for a Dynamic Healthcare Organization

Introduction to Clinical Health Network for Transformation (CHN)

Clinical Health Network for Transformation (CHN) is a pioneering collaboration between Planned Parenthood affiliates across the United States, driven by a shared vision to provide high-quality, affordable care to every member of our communities. As a key player in the healthcare industry, CHN is committed to advancing health and race equity, ensuring that our services are accessible and inclusive for all. We are now seeking a highly motivated and experienced Revenue Cycle Representative to join our team, working remotely from the USA.

About the Role

As a Revenue Cycle Representative at CHN, you will play a vital role in ensuring the timely submission of electronic claims, resolving outstanding balances, and providing exceptional customer service to our patients and insurance payors. Reporting directly to the Revenue Cycle Manager, you will be responsible for a range of activities, including charge entry edits, payment posting, and account resolution. Your expertise and attention to detail will be essential in driving our revenue cycle operations forward, and we are excited to welcome a talented professional like you to our team.

Key Responsibilities

• Resolving pre-bill claim edits and ensuring claims are clean and submitted daily
• Reviewing daily clearinghouse rejections, resolving, and resubmitting accounts
• Posting all insurance and patient payments received through automated and manual channels
• Reviewing aged accounts and taking steps to resolve for payment by contacting payors for claim status, processing rebilling requests, and escalating issues when needed
• Reviewing denied claims to resolve by resubmitting corrected claims or filing claim reconsiderations
• Reconciling all insurance and patient credit balances/overpayments and ensuring a timely refund is processed
• Addressing all channels of patient billing inquiries and escalating as appropriate
• Collecting patient co-pays/coinsurance/deductible amounts due after insurance
• Establishing, monitoring, and pursuing patients with payment plans until reconciliation
• Managing mail and correspondence, as well as other department administrative functions
• Performing various clerical activities to support daily operations
• Creating and promoting a culture of continuous improvement
• Ensuring compliance with all CHN and affiliate policies, as well as all state and federal regulations

Essential Qualifications and Experience

To be successful in this role, you will need:

• 1 to 2 years of relevant account receivable experience
• Previous experience using ICD-10 Medical Coding and Current Procedural Terminology (CPT)
• Knowledge of medical terminology
• Strong analytical and problem-solving abilities
• Proficiency with Microsoft software (Excel, etc.)
• Demonstrated ability to maintain a customer-centric service approach in a fast-paced environment
• Excellent written and verbal communication skills and ability to collaborate and interact with all levels within and outside of CHN
• Strong attention to detail and follow-up; and ability to multi-task in fast-paced environment
• Demonstrated dedication to Planned Parenthood’s mission, vision, and values
• Strong interpersonal skills and the ability to build relationships with stakeholders
• Excellent time management, and problem-solving skills

Preferred Qualifications and Experience

While not essential, the following qualifications and experience are highly desirable:

• Strong General Technology Skills: proficient utilization of Excel, Word, and Windows environment, Epic, eCW, NextGen or other practice management systems experience a plus
• Medical Billing and Coding certification, a plus

Key Requirements

In addition to the essential and preferred qualifications, we are looking for candidates who:

• Are committed to advancing race equity in their work
• Have awareness of multiple group identities and their dynamics, bringing a high level of self-awareness about personal identity, empathy, and humility to interpersonal interactions
• Can demonstrate a commitment to communicating clearly and directly, as well as hearing and acting on feedback related to identity and equity
• Have a strong sense of accountability to equitable practices
• Understand the impact of identity dynamics on organizational culture
• Are committed to CHN and Planned Parenthood’s In This Together service ethos, workplace values, and service standards

Career Growth Opportunities and Learning Benefits

At CHN, we are dedicated to the growth and development of our employees. As a Revenue Cycle Representative, you will have access to a range of training and development opportunities, including:

• Ongoing training and support to ensure your success in the role
• Opportunities for career advancement and professional growth
• A culture of continuous improvement, where your ideas and contributions are valued
• A comprehensive onboarding program to ensure a smooth transition into the role

Work Environment and Company Culture

CHN is a dynamic and inclusive workplace, committed to building a culture of racial and social justice. We value diversity, equity, and inclusion, and are dedicated to creating a work environment that is welcoming and supportive for all employees. As a Revenue Cycle Representative, you will be part of a team that is passionate about delivering high-quality care and advancing health equity.

Compensation, Perks, and Benefits

We offer a competitive compensation package, including:

• A competitive hourly rate, with a minimum of $18.00 per hour
• Geographic differentials available for residences of NYC (Manhattan & Boroughs)
• Comprehensive health care coverage, including medical, dental, and vision
• Flexible spending accounts and health savings account
• Short-term disability and basic life & AD&D insurance provided by CHN
• Voluntary elections for long-term disability and additional life & AD&D insurance available at cost
• Employee assistance program
• Retirement plan, with a 3% employer match after one year of service
• Paid time off program, including accrual-based PTO and nine paid holidays

Conclusion

If you are a motivated and experienced revenue cycle professional, looking for a new challenge and an opportunity to make a real difference in the lives of others, we encourage you to apply for this exciting role. As a Revenue Cycle Representative at CHN, you will be part of a dynamic team, dedicated to delivering high-quality care and advancing health equity. Don’t miss this opportunity to join our team and take your career to the next level. Apply now!