Rev Cycle Representative I

Jefferson Health Plans • Philadelphia, PA

1d

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 steps to resolve them. The role contacts payers about unpaid or denied accounts, obtains information needed to resolve account issues, resolves claim edits with internal departments, updates and reconciles adjustments, and researches payment discrepancies. The representative also maintains knowledge of third-party insurance carriers and applicable regulatory requirements, meets departmental productivity and quality standards, and works independently with minimal supervision.

Requirements

• High school diploma or GED required.
• Epic proficiency.
• Knowledge of commercial and Multiplan payers.

Nice To Haves

• Associate's or bachelor's degree.

Responsibilities

• Contact payers regarding unpaid or denied accounts and follow up within designated timeframes.
• 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 carry out appropriate resolutions.
• Maintain understanding of third-party insurance carriers and regulatory requirements related to receiving full and proper payments.
• Meet productivity and quality requirements defined by departmental policy.
• Work independently with minimal supervision.
• Review correspondence and take appropriate action to expedite resolution of outstanding receivables within established quality and time standards.
• Interact with co-workers, visitors, and other staff consistent with Jefferson's values.

Benefits

• Medical insurance, including prescription coverage
• Supplemental insurance
• Dental insurance
• Vision insurance
• Life and AD&D insurance
• Short- and long-term disability coverage
• 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

What This Job Offers

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