Revenue Cycle Representative

Jefferson Health Plans • Philadelphia, PA

5d • Remote

About The Position

PRIMARY FUNCTION: Responsible for the follow-up with all third party payers, patients and other departments related to outstanding account balances, payment discrepancies and execute resolution. ESSENTIAL FUNCTIONS: Contact payers regarding unpaid or denied accounts. Contact third party payers, hospital departments, and patients to obtain information required for account resolution, i.e. unpaid, denied accounts, payment variances, etc.… Resolve claim edits with internal departments. Update and reconcile adjustments as necessary. Analyze and research payment discrepancies. Determine and execute appropriate action for resolution. Maintains understanding of various third-party insurance carriers and regulatory requirements as related to receiving full and proper payments. Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson. OTHER FUNCTIONS AND COMPETENCIES needed in addition to Essential Functions: Completes account adjustments as required. Reviews correspondence and takes appropriate action to expedite resolution of outstanding receivables with established quality/time standards. Contacts payers regarding unpaid accounts within designated timeframes. Maintains productivity and quality requirements as defined by departmental policy. Other duties as assigned by supervisor. Demonstrated ability to work independently with minimal supervision.

Requirements

• High School Diploma/GED required
• 1-2 years of healthcare revenue cycle experience required
• Ability to communicate clearly (both written and verbal)
• Computer skills, including proficiency in Windows 10 and Microsoft Office
• Demonstrated proficiency in mathematics
• Knowledge of State and Federal healthcare guidelines and regulations
• Strong organizational and interpersonal skills; excellent verbal and written communication skills.

Nice To Haves

• Associates or Bachelor's degree preferred
• Demonstrated understanding of, healthcare terminology, insurance plans and contract language preferred.
• Experience working with Epic preferred

Responsibilities

• Contact payers regarding unpaid or denied accounts.
• Contact third party payers, hospital departments, and patients to obtain information required for account resolution, i.e. unpaid, denied accounts, payment variances, etc.
• Resolve claim edits with internal departments.
• Update and reconcile adjustments as necessary.
• Analyze and research payment discrepancies.
• Determine and execute appropriate action for resolution.
• Maintains understanding of various third-party insurance carriers and regulatory requirements as related to receiving full and proper payments.
• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
• Completes account adjustments as required.
• Reviews correspondence and takes appropriate action to expedite resolution of outstanding receivables with established quality/time standards.
• Contacts payers regarding unpaid accounts within designated timeframes.
• Maintains productivity and quality requirements as defined by departmental policy.
• Other duties as assigned by supervisor.
• Demonstrated ability to work independently with minimal supervision.

Benefits

• Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts.
• Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.
• All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED