A Revenue Cycle Representative is hired to oversee the accounts receivables and collections. Working mostly in healthcare sectors, these representatives undertake the following duties as mentioned on the Revenue Cycle Representative Resume – coordinating billing and collection activities, maximising payments, improving the revenue cycle process, monitoring accounts receivable activity, overseeing monthly close processes, including reporting and account balancing; ensuring accurate billing of insurance providers and patients; documenting medical billing denials from insurance providers; and evaluating billing processes and procedures.
Employers prefer to hire those with the following skills and qualifications – knowledge of HIPAA rules and regulations, supervisory experience, analytical mindset, the ability to ensure that the members adhere to standard protocols and regulations, and relevant software knowledge. A bachelor’s degree in accounting or a related healthcare field is needed.
Summary : Revenue Cycle Representative is responsible for Identifying revenue opportunities; prioritizing revenue growth; creating marketing campaigns; developing forecasting models; tracking the performance of marketing initiatives, Identifying potential customers, analyze market trends, identify their needs, determine the best opportunity to sell or service them; designing marketing campaigns, create inbound marketing programs, and collaborate with sales teams on sales efforts; tracking the performance of marketing initiatives.
Skills : Attention To Detail, Time Management, Analytical Thinker, Willingness To Take Initiative, Flexible Team Player, Dependable, Medical Terminology, Marketing, Typing, Customer Service, Cash Handling, 10-Key, Insurance Verification, Billing.
Description :
Accurately responded to requests for additional information from payers and internal departments within 3 days of requests.
Accurately documented all activity performed daily, on any claim/account in the proper system(s).
Accurately submitted claims to payers (primary, secondary, or tertiary) within 2 days of import into Xclaim, to ensure timely filing guidelines are met for each payer.
Accurately followed- up with payers (primary, secondary, or tertiary) within 2 of days of being assigned.
Provided collection/reimbursement services while ensuring the financial security of accounts in active AR for Ochsner patients to ensure receipt of appropriate cash and other financial adjudications to settle account balances.
Preformed collection and billing activities related to account resolution that includes communication to patients, clients, reimbursement vendors, payers, and other external entities.
Handled bad debt, charity work, cash collections, yield affecting adjustments, accounts receivable days, and accounts receivable days over 90 days.
Experience
7-10 Years
Level
Management
Education
Bachelor Of Arts In Sociology
Revenue Cycle Representative Resume
Headline : Holistic patient care, time management, medication administration injections, have a working knowledge of universal precaution and sterile techniques, observation of patients and reporting, performed care plan monitoring and reassessment, plus patient family education. I am also computer proficient and love working in a fast-paced diverse environment.
Skills : Office Management, People , Posting Charges And Bank Deposits, Office Management, Communications, Billing, Data Entry, Excel, Fax, Quick books, Receptionist.
Description :
Interviewed patients at bedside or in waiting area to verify demographics and insurance information.
Completed registration of all patients in the emergency room.
Scanned insurance cards and retrieve signatures on consent forms.
Collected insurance co-payments.
Scheduled appointment.
Scanned and processed checks, credits, and debits through image center.
Balanced customer accounts.
Experience
5-7 Years
Level
Executive
Education
GED
Revenue Cycle Representative Resume
Objective : Revenue Cycle Representative who impeccably handles clerical and administrative tasks in a fast-paced work environment. Exceptional interpersonal skills, work-flow prioritisation and computer skills. Specialise in health information technology and maintaining patient files in accordance with state and federal requirements.
Skills : Healthcare, Revenue Management.
Description :
Ensured open lines of communication with client.
Addressed emails daily as well as weekly calls to discuss patient and provider needs.
Resolved and communicated insurance issues with patients.
Reviewed outstanding accounts with patients.
Handled patient inquiries and facilitate communication between patients and the office.
Monthly met with client to discuss high balance accounts.
Claimed Submission Coding review and client education on correct coding.
Experience
2-5 Years
Level
Junior
Education
BA
Revenue Cycle Representative Resume
Summary : Possess a positive attitude and motivation that makes the job duties associated with this post easy and fun to do. Knowledge of coding standards and the ability to carry out all processes in a time efficient manner dictate that I have what your company is looking for in terms of quality service.
Skills : E-Clinical Works, And I Have Intermediate Experience With Word And Excel.
Description :
Assigned correct Diagnosis and CPT Codes for maximum reimbursement.
Reviewed payor trends,paymemts,and report findings to management.
Verified patient's eligibility and update demographics in epic.
Submitted appeals to insurance companies with proper documentation.
Worked closely with various specialty groups; i.e. Rheumatoid, OBGYN, Pediatrics, and Dermatology practices.
Reviewed payor contracts to make sure providers are being reimbursed accurately.
Able to help identify errors in our reimbursement rate with Blue Cross that have impacted our A/R.
Experience
7-10 Years
Level
Management
Education
MS
Revenue Cycle Representative Resume
Objective : Revenue Cycle Representative with 3 years of experience in Identifying competitive threats, analyse industry trends, identify key competitors, develop competitive intelligence reports, evaluate competitors' strengths and weaknesses, determine which opportunities are best suited for competitive advantage, Developing competitive intelligence reports to inform strategy formulation, Identifying current market conditions by developing forecasts from data analytics.
Skills : Microsoft, Excel, Data Entry, Data Analysis, Data Analysis, Management, Organisation, Professionalism.
Description :
Served as a Revenue Cycle Specialist for a Hospital Billing Department.
Reviewed A/R reports for rejected claims and denials.
Re-billed claims with corrections and modification to ensure reimbursement for claim.
Identified other problem accounts and worked with billers to resolve problems.
Accessed accounts for authorisations and certifications requirements for billing.
Made settlement agreements on past due accounts with patient and attorneys.
Mailed agreement letters on payment plans and settlement agreements to responsible party.
Experience
2-5 Years
Level
Junior
Education
GED
Revenue Cycle Representative Resume
Headline : Revenue Cycle Representative with 5 years of experience in Identifying customer needs and requirements that align with the business objectives of the organisation, Identifying potential solutions to meet these needs, Communicating these solutions to management in an effective manner, Preparing an annual budget to measure results against goals.
Skills : Medical Billing, Retail Sales.
Description :
Provided excellent customer service to all patients, guests, and family members.
Created, activated, and completed the patient scheduling, clinic registration, or hospital admission process.
Ensured all required forms are completed and other paperwork/documents are gathered and accurate.
Efficiently and accurately gathered and inputs patient/guarantor demographic and financial information; explains insurance benefits and collects co-pays, deductibles and self-pay portions due.
Performed financial analysis of each case and informs patient of financial responsibility Balances Cash drawer daily, prepares deposit slips and follow closing cash drawer process at the end of each shift.
Demonstrated respect and cooperation in all staff relationships, and a genuine willingness to prevent or resolve inter-personal conflicts.
Reviewed patient medical records for use of appropriate ICD-9/10, CPT, HCPCS and NDC codes and make the appropriate corrections.
Experience
5-7 Years
Level
Executive
Education
AA In Human Services
Revenue Cycle Representative Resume
Headline : Revenue Cycle Representative is responsible for Collecting customer data from multiple sources (mail order, in-store, etc.), Analysing trends to identify opportunities for better targeting customer segments, Working closely with sales and marketing to identify business opportunities, Reporting on the results of analysis including recommendations for further action.
Skills : Revenue Management, Production Management.
Description :
Reduced accounts receivable by following up on unpaid claims with third party payors, patients, or other responsible parties, as well as investigating what additional steps must be taken for claims to be properly reimbursed.
Maintained a thorough working knowledge of all aspects of billing and collections including billing rules and regulations, collection practices, electronic billing processes, HCFA 1500 requirements, diagnosis and procedure coding, and applicable county, state, and federal requirements.
Researched & Responded to all incoming and outgoing insurance, patient, and departmental requests.
Assisted in determining solutions to problems created by changes in Insurance Policies.
Assisted in multiple projects while maintaining high productivity standards.
Registered patients in a pleasant, professional, and timely manner, being sensitive to guest services.
Conducted patient/guarantor interviews, explains hospital policies, financial responsibilities, and patient bill of rights.
Experience
5-7 Years
Level
Executive
Education
B.S.
Revenue Cycle Representative Resume
Headline : To obtain a Revenue Cycle Representative position, responsible for Collaborating with product management to create a comprehensive view of the customer experience, Using advanced analytics tools to help understand customer behaviour and help drive revenue, Analysing customers responses through interviews, focus groups or surveys; understanding which features are most important to them.
Called Insurance Companies for status and clarification on denials.
Submitted corrected claims with late charges added or removed or needed modifiers.
Demonstrated and utilised HIPAA law daily.
Worked knowledge of Medicare and Medicaid portals.
Worked knowledge of Commercial Insurance and Medicare HMO's.
Fluctuated throughout each speciality area clinic within the facility.
Experience
5-7 Years
Level
Executive
Education
Diploma
Revenue Cycle Representative Resume
Summary : Seeking a Revenue Cycle Representative position in a setting that utilises experience and skills in the following: I have extensive experience working in a hospital, private, general and medical office setting. I interface well with others at all different type of levels. I am capable of maintaining strict confidentiality with all information.
Submitted payer notifications for inpatient admissions.
Reviewed and resolved claim edits for HMO and Prior Authorisations.
Cross trained in Radiology Prior Authorisations, In-Patient notifications, HMO, and Pre-Access.
Greeted and checked-in patient, and collect personal medical and insurance information.
Scheduled, rescheduled and verified patient appointment.
Coordinated physician schedule and maintain patient flow by communication patient arrival and delays.
Verified insurance coverage's of various carriers, Updated/Input demographic information for patient accounts, scanned, indexed and processed documents.
Experience
10+ Years
Level
Senior
Education
Bachelor Of Business Administration
Revenue Cycle Representative Resume
Summary : Experienced Revenue Cycle Representative with over 10 years experience in working with clinical settings. Skilled in optimising clinic workflows by managing patients flows, physician schedules, and patient appointment. Strong administrative skills, including patient records management and account receivable.
Skills : Excel, Customer Service, Cash Handling, Cashier, Human Resources, Creative writing and academic research.
Description :
Input referrals/ physician orders for providers, Ensured hospital accounts, patient accounts, and workers compensation accounts were assigned properly.
Handled all routine patient inquiries related to the registration process and collection of payments.
Assisted the outpatient radiology authorisation team with pre-service duties, while working collaboratively with doctor's offices and members.
Responsible for all coding work and researching queues for potential coding edits to be implemented.
Defined business goals for the organisation.
Worked with Sales & Marketing to develop strategies to achieve these goals.
Worked with Business Development to identify target customers & solutions that will meet their needs as defined in the business goals.
Creating an account is free and takes five seconds.
You'll get access to the PDF version of this resume template.
Choose an option.
Sign up with Google
Sign up with Facebook
Sign up with Linkedin
This helps us make sure you're human and prevents spammers from abusing our services.
By continuing, you agree to our Privacy Policy and Terms.
Unlock the Power of Over 10,000 Resume Samples.
Take your job search to the next level with our extensive collection of 10,000+ resume samples. Find inspiration for your own resume and gain a competitive edge in your job search.
Get Hired Faster with Resume Assistant.
Make your resume shine with our Resume Assistant. You'll receive a real-time score as you edit, helping you to optimize your skills, experience, and achievements for the role you want.
Get Noticed with Resume Templates that Beat the ATS.
Get past the resume screeners with ease using our optimized templates. Our professional designs are tailored to beat the ATS and help you land your dream job.
