Revenue Cycle Representative

Job description

Accountabilities: Review, analyze, and take appropriate action on complex claim denials, ensuring timely and accurate resolution. Develop and execute appeal strategies, including authorization research, rebilling, and coordination of write-offs or account transfers. Communicate with insurance carriers, patients, and internal hospital departments to gather necessary information for claim resolution. Interpret payer guidelines, contracts, and regulatory requirements to support effective denial management and appeals. Utilize reference materials, payer portals, and direct communication channels to troubleshoot and resolve insurance issues. Maintain accurate documentation and ensure adherence to productivity and quality standards established by the department. Collaborate with cross-functional teams to improve processes and support overall revenue cycle efficiency. Requirements: High school diploma or GED required; associate’s or bachelor’s degree preferred. Minimum of 3 years of experience in hospital revenue cycle, billing, or healthcare financial operations. Strong understanding of insurance plans, payer rules, and healthcare contract language. Knowledge of state and federal healthcare billing and coding regulations. Experience with electronic health record systems, preferably Epic. Proficiency in Microsoft Office and general computer systems (Windows environment). Strong communication skills with the ability to interact professionally with patients, payers, and internal teams. Ability to work independently with strong attention to detail and organizational skills. Benefits: Comprehensive medical, dental, and vision insurance coverage (including prescription benefits) Life insurance, AD&D coverage, and short- and long-term disability protection Retirement savings plans and financial wellness programs Flexible spending accounts (healthcare and dependent care) Tuition assistance and educational advancement opportunities Access to voluntary benefits and employee discount programs Hybrid/remote work flexibility (work-from-home eligible role) Career development and internal growth opportunities within a large healthcare network Inclusive and mission-driven work environment focused on improving patient outcomes. How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether? Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. #LI-CL1 This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Revenue Cycle Representative in the United States. This role is centered on managing complex medical billing and insurance claim resolution within a fast-paced healthcare revenue cycle environment. You will be responsible for reviewing, analyzing, and resolving denied claims by working closely with insurance payers, hospital departments, and patients. The position requires strong analytical thinking and a detailed understanding of healthcare billing processes, insurance regulations, and appeal strategies. You will play a key role in ensuring accurate reimbursement, minimizing revenue loss, and improving the overall financial performance of healthcare operations. Working in a collaborative and service-oriented environment, you will support both internal teams and external stakeholders to resolve billing issues efficiently. This is a strong opportunity for someone who thrives in detail-driven, patient-focused healthcare administration work.