Remote (City) Full-time

Blue Cross & Blue Shield of Rhode Island (BCBSRI) is hiring an Account Representative II

About the Role

LINQ is looking for an Account Representative II to perform key operational responsibilities within our Revenue Cycle Management billing operations. You will be integral to ensuring accurate and compliant billing and follow-up processes while working for one of the world's most respected healthcare organizations.

What You'll Do

  • Recommend and provide input to execute customer service programs in accordance with changes in insurance regulations.
  • Provide supervisors with information to assist in liaising with various departments on issues including contract and reimbursement rules.
  • Comply with, recommend, and assist with implementing management reporting systems to ensure accurate, timely reporting of department results.
  • Assist with department audits as required.
  • Participate in meetings with payors and internal groups to address payment discrepancies and provide data analysis for contract negotiations.
  • Recommend changes in billing practices to reduce payor mis-adjudication and identify problematic contract language.
  • Maintain data and develop enhancements to database and reporting systems to track reimbursement trends, error rates, and maximize recovery.
  • Validate new and existing contracts and reimbursement rules and logic.

What We're Looking For

  • High School Diploma or GED.
  • Two years of patient accounting experience.
  • Knowledge of patient accounts, including customer service, insurance processing, verification, and cash application.
  • Knowledge of specialized functions such as third-party payors, Medicare processing, and hospital and physician billing and pricing.
  • CPT4 and ICD code application skills.
  • Excellent verbal and written communication skills.
  • Knowledge of EPIC and billing revenue resolution.

Technical Stack

  • EPIC

Team & Environment

You will join the Revenue Cycle Management Billing Operations team within the Finance department.

Benefits & Compensation

  • Work alongside passionate caregivers providing patient-first healthcare.
  • Receive endless support and appreciation.
  • Build a rewarding career with a globally respected healthcare organization.

Work Mode

This is a remote position based out of Cleveland.

The policy of Cleveland Clinic Health System and its system hospitals is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment.

Required Skills
EPICCustomer ServiceAccount ManagementSalesCommunicationProblem-SolvingCRM SoftwareMicrosoft OfficeHealthcare Industry Knowledge
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About company
Blue Cross & Blue Shield of Rhode Island (BCBSRI)

A health insurance company dedicated to serving Rhode Islanders, providing access to high-quality, affordable, and equitable care, and improving the health and well-being of the community.

All jobs at Blue Cross & Blue Shield of Rhode Island (BCBSRI) Visit website
Job Details
Category other
Posted 2 months ago