Revenue Cycle Representative II
Jefferson Health Plans•Hilltown Township, PA
•Remote
About The Position
Revenue Cycle Representative II is responsible for reviewing, analyzing and initiating appropriate action for complex case claim denial resolution by communicating with payers, hospital departments and patients.
Requirements
- High School Diploma/GED required
- Minimum 3 years of experience working in hospital revenue cycle
- Working knowledge of insurance plans and contract language
- Computer skills, including proficiency in Windows 10 and Microsoft Office
- Knowledge of State and Federal healthcare billing and coding guidelines.
Nice To Haves
- Associates or Bachelors degree preferred
- Experience working with Epic preferred.
Responsibilities
- Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
- Completes appropriate strategy for an effective appeal including conducting authorization research, rebilling, and balance write off or transfer for next responsible party.
- Corresponds with third party payers, hospital departments, and patients to obtain information required for denial resolution.
- Uses reference material to troubleshoot payer issues and increase understanding of denial resolution techniques. Reference payer websites or contact as needed.
- Maintains understanding of third party regulations for appeals and appeal follow-up.
- Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
- Communicate with patients, insurance carriers, physician’s offices, and other hospital departments in a courteous and professional manner.
- Maintains productivity and quality requirements as defined by department policy.
- Demonstrated ability to work independently with minimal supervision.
- Other duties as assigned by supervisor.
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.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
