PB Revenue Cycle Rep II

Jefferson Health Plans•Philadelphia, PA

1d•Onsite

About The Position

The Payment Research Representative is responsible for handling and reconciling payments received throughout the Jefferson Revenue Cycle Enterprise. Working closely with Payment Representatives, Accounting, and Finance, this role investigates and resolves issues affecting cash processing and reconciliation. The representative applies payments and adjustments to patient accounts, researches payment discrepancies and credit balances, and ensures transactions and batches are accurately processed and reconciled. The position also requires maintaining established productivity and quality assurance standards and communicating potential system or reimbursement issues to a supervisor.

Requirements

High school diploma or GED.
Proficiency in Windows 10 and Microsoft Office, with strong Microsoft Excel and Access skills.
Ability to work independently and as part of a team with minimal supervision.
Proficiency with web tools and technology.
Knowledge of accounting ledgers and balance sheets.
Strong organizational and interpersonal skills.
Excellent verbal and written communication skills.

Nice To Haves

Bachelor’s degree in Accounting, Finance, or Business.
Knowledge of Epic.
EDI-related experience.
Medical billing and/or banking experience.

Responsibilities

Interact with co-workers, visitors, and other staff in a manner consistent with Jefferson’s values.
Identify and resolve payment issues through research and investigation, including reviewing explanations of benefits to confirm payments were applied appropriately.
Contact third-party payors or use payor portals to obtain additional information as needed.
Use online payor portals, such as Navinet, for claims determinations, eligibility, offset requests, and appeals.
Apply payments and adjustments to patient accounts in accordance with third-party regulations while maintaining accurate accounts receivable and balance billing and meeting productivity benchmarks.
Interpret and validate payment and denial transaction postings received through explanation-of-benefit images or electronic remittance posting work queues.
Research over-posted or undistributed credit balances through credit work queues.
Confirm cash records are linked to the appropriate payment batches before posting; ensure batches are posted, reconciled, closed, and processed accurately and on time.
Communicate possible system and reimbursement issues to the supervisor for review and analysis and to confirm an appropriate course of action.
Follow workflows and maintain quality assurance standards.

Benefits

Medical insurance, including prescription coverage.
Supplemental insurance.
Dental insurance.
Vision insurance.
Life and AD&D insurance.
Short- and long-term disability insurance.
Flexible spending accounts.
Retirement plans.
Tuition assistance.
Voluntary benefits, including access to group insurance rates and discounts.
Tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service.
Medical insurance, including prescription coverage, is available to colleagues working less than part-time, including per diem colleagues, adjunct faculty, and Jeff Temps.