REVENUE CYCLE REPRESENTIVE 1

Jefferson Health Plans•Philadelphia, PA

1d•Onsite

About The Position

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. Ability to understand insurance denial codes and take corresponding action to resolve the denial. Knowledge of insurance registration and ability to 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. Ability to meet weekly productivity standards stablished for all staff. Identify and report to supervisor any rejection trends or other issue that affect reimbursement. Experience with Epic follow-up system or other automated follow-up system that requires documentation of actions. Good communications skills as position requires frequent contact with physician practice staff and insurance payor representatives. Flexibility to work in a team environment and to accept special projects. Interacts 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.
Good communications skills
Flexibility to work in a team environment

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 stablished for all staff.
Identify and report to supervisor any rejection trends or other issue that affect reimbursement.
Document actions in Epic follow-up system or other automated follow-up system.
Interact with co-workers, visitors, and other staff consistent with the core values of the University.

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.