Revco Solutions

• Contact consumers to negotiate repayment or establish repayment schedules to resolve delinquent accounts • Provide tools, knowledge, and training for success in the role

• The Hospital Customer Service Representative is the first point of contact for patients reaching out electronically and is responsible for handling inquiries, providing information, and ensuring a smooth and efficient communication process. • Respond to patient inquiries received via hospital website • Ensure timely and accurate handling to all electronic communications. • Assist patients in resolving any concerns or questions related to hospital services. • Maintain a compassionate and professional demeanor in all patient interactions. • Document all electronic interactions in the hospital’s CRM system or relevant databases. • Maintain patient confidentiality in accordance with HIPAA regulations.

• Lead daily operations for the Insurance division across multiple clients, teams, and workflows • Drive productivity, quality, liquidation, and operational performance metrics • Monitor department trends, identify operational risks, and implement corrective action plans • Ensure standardized workflows, documentation practices, and operational consistency across teams • Partner with leadership to support scalable operational processes and workflow optimization • Directly oversee Managers and/or Supervisors within the division • Coach and develop frontline leadership teams to improve accountability, communication, and performance management • Support employee engagement, retention, and leadership development initiatives • Reinforce Revco’s ONE culture and leadership expectations throughout the organization • Support client relationships through operational oversight, reporting review, and issue resolution • Collaborate with internal departments including Training, Human Resources, Technology, and Implementations • Analyze operational and financial performance metrics to identify opportunities for improvement • Assist in development and execution of departmental goals, KPIs, and performance initiatives • Champion continuous improvement initiatives and operational efficiency efforts

• Review disputed self-pay accounts • Confirm patient eligibility of insurance coverage for their services, using multiple host systems and portals • Calls to various payers to confirm eligibility, if a claim is on file and timely filing • Review host systems, add coverage, and electronically bill the claims once the information is verified. • Other assigned duties and needs

• Answering inbound calls from patients and addressing any inquiries, concerns, or requests with empathy and professionalism. • Assisting patients with insurance inquiries, claims, and billing matters. • Providing information about medical procedures, services, and general healthcare inquiries. • Documenting patient interactions and updating relevant systems according to established guidelines.

• Handle and resolve assigned group of accounts • Resolve and recover lost revenue from these denials • Investigate the issues and attempt to overturn the denial to get the claims paid

• Completes medical insurance follow-up process accurately and timely for a designated group of accounts • Analyzes, researches and prepares insurance claims to be submitted to insurance carriers • Responds to all inquiries, billing denials, and other correspondence and phone requests • Attaches necessary documentation when mailing claims to payors • Handles telephone inquiries on delinquent claims • Maintains excellent rapport with the customer • Resolves problem accounts independently using sound judgement • Documents activity within client’s patient accounting system and EOS systems • Maintains all reports, files, and records as needed • Meets and maintains quality assurance standards as determined by management

• Serve as the organization's primary point of contact and subject matter expert for all leave of absence matters, including FMLA, ADA/ADAAA accommodations, personal leave, military leave, and state-specific leave entitlements • Manage the full leave lifecycle: intake, eligibility determination, certification review, designation notices, tracking, return-to-work coordination, and recordkeeping • Lead the interactive process under the ADA/ADAAA; collaborate with employees, managers, and medical providers to identify and implement reasonable accommodations • Process short-term and long-term disability claims; serve as liaison with disability insurance carriers and ensure continuity of pay and benefits during leave periods • Maintain current knowledge of multi-state leave laws and proactively communicate changes that affect leave administration practices • Ensure all leave documentation is completed accurately, retained appropriately, and handled in strict compliance with confidentiality requirements • Administer employee benefits programs including medical, dental, vision, life, disability, FSA/HSA, and voluntary supplemental plans • Process new hire enrollments, qualifying life event changes, and annual open enrollment; partner with benefits broker and carriers to resolve issues • Serve as a knowledgeable resource for employees navigating benefits questions, claims issues, and plan comparisons • Serve as a trusted resource for employees and managers on HR policies, workplace concerns, and employee relations matters • Conduct thorough and impartial workplace investigations; document findings and recommend appropriate resolutions • Support management in addressing performance issues, coaching conversations, and progressive discipline • Manage onboarding and offboarding processes to ensure a consistent and compliant employee experience • Process employment verifications and respond to unemployment claims • Maintain accurate employee files and HR records in compliance with company policy and legal retention requirements • Ensure ongoing compliance with federal, state, and local employment laws across all HR functions • Participate in policy development, updates, and implementation; communicate changes clearly to employees and managers

• Conduct detailed analysis and follow-up on outstanding insurance claims (both commercial and government), ensuring timely and accurate resolution in accordance with payer guidelines. • Research and resolve claim denials, rejections, and underpayments by initiating appropriate billing corrections, appeals, and resubmissions. • Prepare and submit claim documentation—including EOBs, itemized statements, and medical records—as required by payers to support claim adjudication. • Respond to payer and patient inquiries related to delinquent claims, maintaining compliance with privacy regulations and payer contract guidelines. • Utilize payer portals, Electronic Health Records (EHR), and patient accounting systems to investigate claim status, post notes, and manage follow-up activities. • Identify trends in denials and payment delays, contributing to process improvement initiatives and strategies for reducing AR days. • Maintain accurate and detailed records of account activity, ensuring that production goals and quality standards are consistently met or exceeded. • Demonstrate strong communication skills when interacting with insurance representatives, patients (as appropriate), and internal departments to resolve outstanding issues. • Prioritize and organize daily workload effectively to meet departmental benchmarks in a fast-paced, high-volume environment. • Provide support on special projects and additional assignments as requested by management

• Maintain/develop constructive and cooperative working relationships with clients over time. • Confer with clients by telephone to provide or obtain information including updating account statuses, consumer contact information, or other additional information relating to the collection of debts. • Strive to respond to client inquiries received within the same business day. • Keep records of client interactions, recording details of inquiries, complaints, or comments, as well as actions taken within the system. • Check to ensure that appropriate changes were made to resolve client concerns or inquiries. • Promptly refer unresolved client inquiries to designated departments for further investigation/review. • Promptly process itemized bill requests and utilize WebNow for obtaining/processing disputes, when applicable. • Send notification to the client of final bill requests, balance/payment verifications, disputes, and instances of fraud and/or identity theft and follow up on responses received. • Post direct payments. • Access client websites when applicable to assist with consumer resolutions. • Process monthly client statements providing payment details and invoice to clients and reconcile any disputes. • Participate in audits, client visits, external client meetings, conference calls and summits, as necessary. • Ensure all process and procedure documentation are kept current. • Client Services must adhere to and be compliant with FDCPA, FCRA, FACTA, Regulation E, HIPAA, TCPA and other applicable federal, state, and local laws as well as company policies and procedures. • Abide by all policies as outlined within Revco Solutions Employee Handbook.