Revenue Cycle Representative II

Jefferson Health Plans•Einstein Hospice - Old York Rd, PA

1d•Onsite

About The Position

The Payment Research Representative is responsible for properly handling and reconciling payments received throughout the Jefferson Revenue Cycle Enterprise. Working closely with Payment Representatives, Accounting, and Finance, the representative investigates and resolves issues affecting cash processing and reconciliation. The role applies payments and adjustments to patient accounts in accordance with third-party regulations, supports accurate accounts receivable and balance billing, and meets established productivity benchmarks. The representative also ensures payment batches are accurately posted, reconciled, closed, and processed in a timely manner, and follows workflows and quality assurance standards.

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.
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.
Research and investigate payment issues and review explanations of benefits to confirm payments were applied appropriately.
Contact third-party payors or use payor portals to obtain additional information.
Use online payor portals, such as Navinet, for claims determination, eligibility, offset requests, and appeals.
Apply payments and adjustments to patient accounts according to third-party regulations while maintaining accurate accounts receivable and balance billing and meeting productivity benchmarks.
Interpret and validate transaction postings of payments and denials received through third-party explanations of benefits, whether in batched images or electronic remittance posting work queues.
Research over-posted or undistributed credit balances using credit work queues.
Confirm cash records are properly linked to 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 and analysis and confirmation of the appropriate course of action.
Follow established 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 coverage.
Flexible spending accounts.
Retirement plans.
Tuition assistance and tuition discounts at Thomas Jefferson University, subject to service eligibility.
Voluntary benefits, including access to group insurance rates and discounts.