RCM Representative

Position Summary

The Revenue Cycle Representative at SENTA Partners plays a key role in managing the financial health of our healthcare organization. This position is responsible for processing claims, managing accounts receivable, following up on denied or outstanding claims, and ensuring timely and accurate billing. The ideal candidate is detail-oriented, proactive, and has strong communication and analytical skills.

Key Responsibilities

Claims Processing: Prepare and submit accurate claims to insurance carriers, ensuring compliance with payer guidelines and coding standards.
Accounts Receivable Management: Monitor and manage accounts receivable balances, including following up on unpaid or denied claims.
Denial Management: Research and resolve claim denials and rejections by analyzing reasons for denial, identifying corrective actions, and resubmitting claims when appropriate.
Payment Posting: Accurately post payments received from insurance companies and patients, including electronic and manual payments.
Patient Account Management: Assist with patient billing inquiries, resolve payment discrepancies, and facilitate payment arrangements.
Revenue Cycle Reporting: Generate and analyze revenue cycle reports to monitor key performance indicators (KPIs) such as days in AR, denial rates, and collection ratios.
Compliance: Ensure all billing activities are compliant with state and federal regulations, payer requirements, and organizational policies.
Collaboration: Work closely with the clinical staff, billing team, and revenue cycle management to address issues impacting revenue cycle performance and provide feedback for process improvement.

Requirements
Qualifications

High School Diploma.
2 years’ experience preferred.
Excellent verbal and written communication skills.
Excellent organizational skills and attention to detail.
Maintains professional friendly attitude.
Excellent knowledge of payor policies and guidelines.
Familiarity with coding guidelines.