Rev Cycle Representative I

Jefferson Health Plans

109d

About The Position

The Revenue Cycle Representative I is responsible for the follow-up with all third-party payers, patients, and other departments related to outstanding account balances and payment discrepancies. This role involves contacting payers regarding unpaid or denied accounts, obtaining necessary information for account resolution, and resolving claim edits with internal departments. The representative will analyze and research payment discrepancies, determine appropriate actions for resolution, and maintain an understanding of various third-party insurance carriers and regulatory requirements. The position requires maintaining productivity and quality standards as defined by departmental policy and the ability to work independently with minimal supervision.

Requirements

• High School Diploma/GED required.
• Associates or Bachelor's degree preferred.
• Demonstrated ability to work independently with minimal supervision.

Responsibilities

• Follow up with third-party payers, patients, and other departments regarding outstanding account balances and payment discrepancies.
• Contact payers about unpaid or denied accounts.
• Obtain information required for account resolution, including unpaid, denied accounts, and payment variances.
• Resolve claim edits with internal departments.
• Update and reconcile adjustments as necessary.
• Analyze and research payment discrepancies.
• Determine and execute appropriate actions for resolution.
• Maintain understanding of various third-party insurance carriers and regulatory requirements.
• Review correspondence and take appropriate action to expedite resolution of outstanding receivables.

Benefits

• Comprehensive medical insurance (including prescription).
• Supplemental insurance.
• Dental and vision insurance.
• Life and AD&D insurance.
• Short- and long-term disability.
• Flexible spending accounts.
• Retirement plans.
• Tuition assistance.
• Access to group rates on insurance and discounts.
• Tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service.

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 501-1,000 employees