Revenue Cycle Representative

Description

Planned Parenthood of Central and Western New York (PPCWNY) protects and provides health care and education that empowers individuals and families. With respect. Without judgment. No matter what.

Diversity and inclusion are core values at Planned Parenthood of Central and Western New York (PPCWNY). PPCWNY recruits exceptional and diverse staff. PPCWNY strives to develop staff into leaders for a diverse and global workplace.

In support of Planned Parenthood of Central and Western New York (PPCWNY)’s mission, the Revenue Cycle Representative (RCR) has responsibility to ensure effective collections on all patient accounts and provides support to the Revenue Cycle Manager in assigned revenue cycle functions. In Collaboration with health center staff, Insurance Benefit Coordinators (IBCs) and Medical Billers, the RCR evaluates patient charges to identify active third-party insurance or eligibility to enroll in state sponsored insurance programs, monitors patient accounts and responds to patient account questions. This position has responsibility across three NYS affiliates through Shared Services; Planned Parenthood Central Western New York, Upper Hudson Planned Parenthood, and Planned Parenthood of the North Country New York.

• Performs charge review of self pay encounters
• Works in collaboration with Billing and IBC staff to identify potential to bill insurance or enroll in state sponsored insurance programs
• Processes payments from patients and maintains accurate patient account records
• Reconciles and posts the Phreesia and InstaMed self-pay payment batches
• Answers patient calls and addresses questions related to insurance and patient responsibility
• Performs systematic, consistent, and timely collection follow up including phone calls and past due letters on accounts with outstanding balances according to patient collections policies and procedures
• Establishes payment plans and follows up on patient accounts with established payment plans
• Reviews patient statement reports for accuracy and prepares statements
• Reviews the unapplied payment reports and apply payments
• Processes credit balances and donation request letters on a timely basis to ensure overpayments are addressed
• Performs small balance write-offs and bad debt adjustments
• Performs review of Lab Report, reconciles with PM, and submits to Finance for payment
• Performs job duties in a confidential, ethical, and professional manner in adherence to corporate compliance standards as well as applicable regulations and laws
• Works in collaboration with staff in other functional areas of the organization to successfully accomplish objectives and meet internal goals
• Interprets and applies policies; identifies and recommends changes or workflow improvements
• Notifies Revenue Cycle Manager of any collection or workflow issues
• Assists with training of other staff.

Customer Service

• Performs all duties in accordance with established agency policies, protocol and the In This Together services ethos, workplace values, and service standards.
• Builds and maintains positive relationships with customers, both internal (colleagues) and external (patients, clients, donors etc.)
• Acts in the best interests of the patient.
• Demonstrates commitment to exceeding customer expectations at every opportunity
• Responds positively to customer concerns and demonstrates effective problem-solving skills.
• Shows respect to all internal and external customers for differences in backgrounds, lifestyles, viewpoints and needs in areas such as race, gender, ethnicity, creed, sexual orientation and others

Other Accountability Activities

• Attends and participates in team meetings and other required meetings or training opportunities including education on insurance rules and regulations
• Assists with training of other staff
• Participates in affiliate initiatives
• Performs other duties as assigned by the Billing Manager
• Adheres to PPCWNY safety and security rules, policies, and procedures and HIPAA confidentiality standards.

Requirements

Applicants must possess the following qualifications (or equivalent combination of education and experience):

Education—

• Associate’s degree in business, accounting, business administration, or a related field or equivalent combination of education and experience preferred

Experience—

• Three years of experience in medical bil