Revenue Cycle Lead

Jefferson Health Plans • Abington Township, PA

1d

About The Position

The Lead Enrollment & Revenue Cycle Specialist supports the Revenue Cycle operations by serving as a key resource to staff and assisting supervisory personnel with daily workflow coordination and process oversight. This role combines cash operations leadership with provider enrollment expertise to ensure accurate reimbursement, operational efficiency, and compliance across the revenue cycle. Essential Functions Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.

Requirements

• Must demonstrate strong interpersonal, organizational, and communication skills.
• Ability to work independently and as a team member.
• Effective problem-solving skills required.
• Must be able to meet departmental goals on an ongoing basis.
• Experience with revenue cycle applications/systems
• Awareness of compliance and regulatory guidelines
• Working knowledge of Microsoft Word and Excel.
• Knowledge healthcare claims processing and payment workflows
• Experience in claims processing
• High School Diploma/Equivalent
• 4 years’ experience in a healthcare/revenue cycle setting with specific experience in business functions such as; registration, follow up, denials, and payment posting.

Responsibilities

• Complete and maintain all initial and ongoing provider enrollment applications for commercial and government payers, including full oversight of CAQH profiles, NPI records, and related provider data to ensure accuracy and compliance
• Configure and maintain Electronic Funds Transfer (EFT), Electronic Data Interchange (EDI), and Electronic Remittance Advice (ERA) with payers, clearinghouses, banking partners, and internal systems (including Epic), ensuring accurate electronic data exchange and timely reimbursement.
• Serve as the primary liaison with payers and clearinghouse to initiate and manage enrollment communications, monitor payment methods for cost effectiveness, and track/report enrollment status using established tracking tools; proactively follow up to resolve delays or discrepancies.
• Support supervisory staff in managing daily departmental operations and workflows, driving increased automation in payment processing to enhance efficiency, accuracy, and alignment with departmental objectives.
• Provide training, mentoring, and day-to-day guidance to team members; serve as a resource for troubleshooting issues and escalating systemic concerns as needed.
• Assist in the development, maintenance, and documentation of standard operating procedures (SOPs) to promote operational consistency and efficiency across the revenue cycle team.

Benefits

• Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts.
• Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.
• All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED