Revenue Cycle Representative II

Jefferson Health Plans • Einstein 60 Township Line Road, PA

7d

About The Position

The Payment Research Representative is responsible for handling and reconciling payments received throughout the Jefferson Revenue Cycle Enterprise. Working with Payment Representatives, Accounting, and Finance, the representative investigates and resolves issues affecting cash processing and reconciliation. The role also applies payments and adjustments to patient accounts, researches transaction and credit-balance issues, and ensures payment batches are accurately processed and reconciled.

Requirements

• High school diploma or GED.
• Proficiency in Windows 10 and Microsoft Office; strong Microsoft Excel and Access skills are required.
• 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, with 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 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 determination, eligibility, offset requests, and appeals.
• Apply payments and adjustments to patient accounts in accordance with third-party regulations, maintaining accurate accounts receivable and balance billing while meeting department productivity benchmarks.
• Interpret and validate payment and denial transaction postings from third-party explanations of benefits, whether received as batched images or through electronic remittance posting work queues.
• Research over-posted or undistributed credit balances through credit work queues.
• Confirm cash records are linked to their associated payment batches before posting, and ensure batches are posted, reconciled, closed, and processed accurately and on time.
• Communicate potential system and reimbursement issues to the supervisor for review, analysis, and confirmation of the appropriate 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
• 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