Revenue Cycle Representative I
Jefferson Health Plans•Philadelphia, PA
•Remote
About The Position
The Revenue Cycle Representative I follows up with third-party payers, patients, and other departments regarding outstanding account balances and payment discrepancies, and carries out appropriate resolutions. The role involves researching account issues, obtaining information needed to resolve claims, maintaining knowledge of insurance carriers and applicable regulations, and meeting departmental quality and productivity standards. The position is eligible for telecommuting (work from home).
Requirements
- High school diploma or GED required.
- 1–2 years of healthcare revenue cycle experience required.
- Ability to communicate clearly, both verbally and in writing.
- Computer skills, including proficiency in Windows 10 and Microsoft Office.
- Demonstrated proficiency in mathematics.
- Knowledge of state and federal healthcare guidelines and regulations.
- Strong organizational and interpersonal skills.
- Demonstrated ability to work independently with minimal supervision.
Nice To Haves
- Associate or bachelor's degree preferred.
- Understanding of healthcare terminology, insurance plans, and contract language preferred.
- Experience working with Epic preferred.
Responsibilities
- Contact payers regarding unpaid or denied accounts.
- Contact third-party payers, hospital departments, and patients to obtain information needed to resolve unpaid or denied accounts and payment variances.
- Resolve claim edits with internal departments.
- Update and reconcile adjustments as necessary.
- Analyze and research payment discrepancies and determine and execute appropriate resolutions.
- Maintain understanding of third-party insurance carriers and regulatory requirements related to receiving full and proper payments.
- Interact with co-workers, visitors, and other staff consistently with Jefferson's values.
- Complete account adjustments as required.
- Review correspondence and take appropriate action to expedite resolution of outstanding receivables within established quality and time standards.
- Contact payers about unpaid accounts within designated timeframes.
- Maintain productivity and quality requirements defined by departmental policy.
- Perform other duties as assigned by the supervisor.
Benefits
- Medical insurance, including prescription coverage
- Supplemental insurance
- Dental insurance
- Vision insurance
- Life and AD&D insurance
- Short- and long-term disability
- 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 all colleagues, including those working less than part-time
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
