Revenue Cycle Representative II

Jefferson Health Plans•Dixon Hall (formerly Pennwood), PA

1d•Onsite

About The Position

The Revenue Cycle Representative II is responsible for ERA and EFT enrollment to ensure accurate reimbursement, operational efficiency, and compliance across the revenue cycle. This role involves interacting with co-workers, visitors, and other staff consistent with the values of Jefferson. The representative will provide and maintain W-9 documentation for payers, review 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). They will also assist with payers and clearinghouses to initiate and manage enrollment communications, monitor payment methods for cost effectiveness, and track/report enrollment status. Researching payer capabilities and enrolling live check via ERA and EFT where available is also a key function. Additionally, the role assists in the maintenance and documentation of standard operating procedures (SOPs) and an enrollment playbook to promote operational consistency and efficiency.

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

Provide and maintain W‑9 documentation for payers upon request to support payer enrollment, contractual requirements, and timely reimbursement.
Review 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.
Assist 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.
Research payer capabilities and enroll live check via Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) where available to support electronic payment optimization and efficiency.
Assist in the maintenance, and documentation of standard operating procedures (SOPs) and enrollment playbook to promote operational consistency and efficiency across the revenue cycle team.
Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.

Benefits

medical (including prescription)
supplemental insurance
dental
vision
life and AD&D insurance
short- and long-term disability
flexible spending accounts
retirement plans
tuition assistance
voluntary benefits
tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.