Revenue Cycle Representative

Job Details

Revenue Cycle Representative I

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.

• 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 time frames.
• Maintains productivity and quality requirements as defined by departmental policy.
• Other duties as assigned by supervisor.
• Demonstrated ability to work independently with minimal supervision.
• 1-2 years of healthcare revenue cycle experience required
• Demonstrated understanding of, healthcare terminology, insurance plans and contract language preferred.
• 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
• Experience working with Epic preferred
• ADDITIONAL INFORMATION:
• Strong organizational and interpersonal skills; excellent verbal and written communication skills.
• Position is eligible for telecommuting (work from home).

Workday Day (United States of America)

Regular

Albert Einstein Medical Center

60 Township Line Road, Elkins Park, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow’s professional leaders for 21st-century careers;

and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region.

Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for…