REVENUE CYCLE REPRESENTIVE 1
About The Position
The Revenue Cycle Representative will be responsible for following up with insurance payors on rejected or underpaid claims, initiating claim reviews where appropriate, and working open claims in a timely manner to maximize reimbursement. This role involves resubmitting claims to insurance payors with appropriate modifications, understanding insurance denial codes and taking corresponding actions to resolve them, and utilizing payor websites to verify patient eligibility. The representative must stay current with insurance payor rules and regulations, meet weekly productivity standards, and identify and report any rejection trends or issues affecting reimbursement to their supervisor. Experience with an automated follow-up system like Epic is required, along with good communication skills for frequent contact with physician practice staff and insurance payor representatives. Flexibility to work in a team environment and accept special projects is also necessary. The role requires interacting with co-workers, visitors, and other staff consistent with the core values of the University.
Requirements
- High School degree or GED equivalent required.
- Two to three years accounts receivable/billing experience in a physician practice, hospital or ancillary medical billing office.
- Experience in insurance claims processing.
- Experience with Epic follow-up system or other automated follow-up system that requires documentation of actions.
- Good communication skills.
- Flexibility to work in a team environment.
- Ability to meet weekly productivity standards.
Nice To Haves
- Willing to train college graduates.
- Preferred knowledge of third party rules and regulations.
- Knowledge of ICD-10 and CPT coding preferred.
- Experience in Epic billing system highly desirable.
Responsibilities
- Follow-up with insurance payors on rejected or underpaid claims.
- Initiate claim reviews where appropriate.
- Work open claims in a timely manner to maximize reimbursement.
- Resubmit claims to insurance payors with appropriate modifications.
- Understand insurance denial codes and take corresponding action to resolve the denial.
- Use payor websites to verify patient eligibility.
- Remain current and knowledgeable regarding insurance payors rules and regulations such as Medicare, Medicaid, BC/BS and commercial carriers.
- Meet weekly productivity standards established for all staff.
- Identify and report to supervisor any rejection trends or other issues that affect reimbursement.
- Document actions in an automated follow-up system.
- Communicate effectively with physician practice staff and insurance payor representatives.
- Work in a team environment and accept special projects.
- Interact with co-workers, visitors, and other staff consistent with the core values of the University.
Benefits
- Medical (including prescription) insurance
- 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 (access to group rates on insurance and discounts)
- 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
Entry Level
Education Level
High school or GED
