H
HEMPHILL COUNTY HOSPITAL DISTRICT
Revenue Cycle Representative - Full-Time
9 months ago
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Important information
Location:
Canadian, TX 79014, USA
Work mode:
Onsite
Published on:
2 September 2026
What they need
| JOB SUMMARY |
| Overview: Responsible for claim submission and claim resolution for patients in regard to governmental, commercial insurance companies, and patient accounts. |
| MAJOR RESPONSIBILITIES |
| Essential Duties and Responsibilities: 1. Works individual portfolio of accounts from billing/collection system 2. Assesses insurance reimbursement for individual supplies to ensure maximum reimbursement 3. Verifies that all appropriate supporting documentation is obtained prior to billing 4. Audits supporting documentation, formulary requirements, and manufacturer compatibility 5. Posts payments and/or adjustments to individual accounts 6. Resolves credit balance accounts 7. Identifies problems or improvements within own area, develops resourceful and alternative solutions for work improvement or problem solution 8. Researches and follows up on all correspondence associated with assigned accounts, including EOB’s and documentation letters, and generate correspondence requesting required information when necessary 9. Initiates appeals and ensures all required documentation is submitted in the appeals process; researches all denials and follows up as necessary 10. Places outbound calls to/from insurance companies and patients to collect outstanding funds· 11. Reduces delinquent accounts and achieves maximum collections from all sources 12. Produces reports identifying trends or problem carriers, identifies areas of concern, and presents ideas to correct or prevent future issues 13. Analyzes and corrects accounts receivable problems 14. Documents all activities as completely as possible. 15. Achieves productivity goals 16. Must maintain a high degree of confidentiality at all times due to access to sensitive information. 17. Assist the Patient Financial Services Department with patient registration 18. Complete other duties as assigned 19. Attends department/division meetings and training sessions including required to attend meetings at differing times from normal work hours as directed Miscellaneous Duties and Responsibilities: 20. Completes other duties as assigned 21. Maintains confidentiality of sensitive information as a Payment Specialist/HIM Clerk 22. Documents work processes as required by HCH policies and department policies and procedures. ALLDUTIESANDREQUIREMENTSMUSTBEPERFORMEDCONSISTENTWITHTHEHCHDPERFORMANCESTANDARDS |
| JOB REQUIREMENTS | ||
| Education | Minimum | High School Diploma or GED equivalent. |
| Preferred | ||
| Work Experience | Minimum | - Proficient in basic PC skills (MS Office Suite); proficient in mathematical skills and medical terminology - Excellent oral and written communication skills; proficient use of oral and written English - Organized work habits, accuracy, and proven attention to detail with strong analytical skills - Minimum of two years of medical billing/collections experience necessary; must be knowledgeable of reimbursement processes and procedures - Ability to interpret rules and regulations required by Medicare, Medicaid, and Commercial payers - Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals; ability to write routine reports and correspondence. - Ability to recommend and implement changes to processes for efficiency - Self-directed with the ability to work at times with little or no supervision - Flexible and cooperative in fulfilling all assigned obligations - Ability to work with others as a team member, provide assistance as needed, and contribute individually - Ability, flexibility, and willingness to learn and grow as the organization expands and changes |
| Preferred | - Prefer knowledge/prior use of electronic health/medical record database technology | |
| Licenses & Certifications | Minimum | Maintain CPR certification as a condition of employment |
| Preferred |
| Required Skills, Knowledge, and Abilities | 1. Consistent availability to work Monday to Friday from 8:00 AM to 5:00 PM as a regular full-time, nonexempt employee. 2. Excellent command of the English language (reading, writing, and speaking) is essential. 3. Demonstrated computer skills appropriate for the position 4. Demonstrated critical thinking, ability to analyze complex situations, and ability to apply policy 5. Ability to maintain accurate records 6. Excellent organizational and interpersonal communication skills 7. Demonstrated ability to manage multiple priorities 8. Ability to communicate information effectively and to respond adequately to questions from groups of managers, clients, customers, vendors, and physicians Other Requirements: 9. Must convey a professional demeanor 10. Must be able to act calmly and efficiently in a busy or stressful situation 11. Ability to communicate effectively in the English language in person, by phone, and in writing 12. Adheres to all policies and procedures, including standards for safety, attendance, punctuality, and personal appearance 13. Must be able to establish and maintain positive working relationships with managers and peers | |||||||
| AGE SPECIFIC COMPETENCY (Clinical jobs only) Identify age-specific competencies for direct and indirect patient care providers who regularly assess, manage and treat patients. | ||||||||
| **Instructions:**Indicate the age groups of patients served either by direct or indirect patient care by checking the appropriate boxes below. Next, | ||||||||
| X | Infants (Birth – 11 months) | X | Adolescent (13 – 19 years) | |||||
| X | Toddlers (1 – 3 years) | X | Young Adult (20 – 40 years) | |||||
| X | Preschool (4 – 5 years) | X | Middle Adult (41 – 65 years) | |||||
| X | School Age (6 – 12 years) | X | Older Adult (Over 65 years) | |||||
| JOB FUNCTIONS Review the employee’s job description and identify each essential function that is performed differently based on the age group of the patient. | ||||||||
| PHYSICAL REQUIREMENTS | ||||||||
| *Indicatetheappropriatephysicalrequirementsofthisjobinthecourseofa***shift.Note:reasonableaccommodationsmay be made available for individuals with disabilities to perform the essential functions of this position. | ||||||||
| PhysicalDemandLevel | Occasional Up to 33% of the time | Frequent 34%-66% of the time | Constant 67%-100% of the time | |||||
| **Sedentary:**Ability to lift up to 10 pounds maximum and occasionally lifting and/or carrying such articles as dockets, ledgers and small tools. Although a sedentary job is defined as one, which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met. | Upto10# | Negligible | Negligible | |||||
| X | **Light:**Ability to lift up to 25 pounds maximum and occasionally lifting and/or carrying such articles as dockets, ledgers and small tools. Although a sedentary job is defined as one, which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met. | Upto25# | **Up to 10#**or requires significant walking or standing, or requires pushing/pulling of arm/leg controls | Negligibleor constant push/pull of items of negligible weight | ||||
| **Medium:**Ability to lift up to 50 pounds maximum with frequent lifting/and or carrying objects weighing up to 25 pounds. | **20-**50# | **10-**25# | **Negligible-**10# | |||||
| **Heavy:**Ability to lift up to 100 pounds maximum with frequent lifting and/or carrying objects weighing up to 50 pounds. | **50-**100# | **25-**50# | **10-**20# | |||||
| **Very Heavy:**Ability to lift over 100 pounds with frequent lifting and/or carrying objects weighing over 50 pounds. | Over****100# | Over****50# | Over****20# | |||||
| List any other physical requirements or bona fide occupational qualifications: | - Physical demands described herein represent those that must be met by an employee to perform successfully the essential functions of the job - Requires manual dexterity sufficient to operate a keyboard, calculator, telephone, copier, scanner, and other similar office equipment/machines - Reasonable accommodations to perform the essential functions may be made for individuals with disabilities - While performing the duties of this job, the employee is required to sit for long periods of time; stooping, bending, stretching—as for reaching files and/or supplies—is required; occasional lifting of objects to 25 pounds is required |
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