Revenue Cycle Representative

Since its inception more than 60 years ago, General Vision Services (TM) has been proudly serving more than 3 million members of unions, HMOs and corporations. GVS continues to be a leading Eyecare Benefits Administrator and Preferred Provider Organization (PPO) provider of eyecare plans nationally.

We are seeking a Revenue Cycle Representative that is a dedicated, driven professional who takes initiative and has the necessary skills to be able to fulfill all functions of the revenue cycle including processing of claims, following up on aging revenue, payment posting and collections for our Vision and Hearing service lines.  

Responsibilities include, but are not limited to: 

• Review all billing guidelines, benefits verifications, and coding, as required, based on the designated client. 
• Claim Billing and collection for multiple clients, one of which may include Audiology billing and collecting for over 100 Providers in multiple states. 
• Follow up with insurance on pending payments via phone, web portal and/or fax and expedite claim processing. 
• Review patient demographic, insurance carrier information and reconciliate payments to maintain a clean AR. 
• Understanding of eligibility benefits and claims processing to identify discrepancies for claim resolution. 
• Review EOB’s/contracts and fee schedules to ensure maximum cash collections. 
• Process payments from insurance companies, prepare daily deposits and apply manual payments/adjustments/write offs based on Explanation of Benefits in a timely manner. 
• Gather trends relevant to AR scenarios to report to management progression of collection and AR monitoring. 
• Perform denial management functions by resolving incoming denials through appeals or reprocessing of claims. 
• Respond to customer and insurance inquiries via mail, email, fax or phone call in a timely manner. 
• Communicating with and assisting patients with billing questions, inquiries and collecting payments. 
• Provide feedback and suggestions on workflow improvement, trends, and areas of opportunity. 
• Review fee schedules to ensure proper payment (as required by client) and submit appeals as needed. 
• Knowledgeable in multiple processes of the RCM Department and able to provide coverage for any team including but not limited to:  follow up, cash receipts, customer service, denial management and/or special projects. 
• Maintain strict confidentiality; adheres to all HIPAA guidelines/regulations. 

Qualifications & Skills: 

• Problem Solving & Results Oriented, willing to take initiative 
• Strategic Planning & Time Management 
• Proficient written & verbal communication skills; interpersonal skills 
• Knowledge of medical billing preferred.  
• Must possess self-motivation, enthusiasm, and a positive attitude, and perform as a team player. 
• Strong attention to detail and organizational skills 
• Must be capable of multi-tasking in a fast-paced environment. 

Preferred Experience: 

• High School diploma or GED required with at least two (2) years’ experience in the healthcare field or in a similar position. 
• MS Office, Word, Excel, Outlook, PowerPoint. 
• Insurance Provider Portals. 

Work Environment & Culture: 

• Possibility for hybrid work environment. 
• Active participation in team huddles, department meetings, etc. 
• Learning & growing environment; Opportunities for professional development and career growth 
• Ability to adapt as improvements are always being made in this fast-growing environment. 
• Accountability to meet and exceed success metrics and KPIs. 
• Opportunity to become part of a developing, growing and highly skilled team. 

Benefits: 

• 401k 
• Health, Dental & Vision Insurance 
• Flexible Spending Account & Health Savings Account 
• Paid time off 
• Paid training 
• Hybrid/Work from home opportunities 

Schedule: 

• 8 hour shift; Monday to Friday 
• Hours:  9:30am-5:30pm

GVS is an equal opportunity employer and value diversity in our workforce. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or any other protected characteristic. 

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