Revenue Cycle Representative II

The Payment Research Representative is responsible for proper handling and reconciliation of payments received throughout the Jefferson Revenue Cycle Enterprise. Working closely with Payment Representatives, Accounting and Finance, the Payment Research Rep will investigate and resolve issues impacting cash processing and reconciliation.

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
• Identify and resolve payment issues through research and investigation.
• Review explanation of benefits to confirm payments were applied appropriately.
• Contact third‑party payors or view payer portals to obtain additional information as necessary.
• Utilize online payer portals, such as Navinet, for claims determination, eligibility, offset requests, and appeals.
• Apply payment and adjustments to patient accounts per third‑party regulations, providing accurate accounts receivable and balance billing while meeting the department’s established productivity benchmarks.
• Interpret and validate transaction postings of payments and denials received from third‑party explanation of benefits either in the form of batched images or via electronic remittance posting work queues.
• Research over‑posted or undistributed credit balances via credit work queues.
• Confirm that cash records are properly linked to associated payment batches prior to posting.
• Ensure that batches are posted, reconciled, closed and processed timely and accurately.
• Communicate possible system and reimbursement issues to the supervisor who will facilitate a review and analysis of the potential impact and confirm best course of action.
• Adhere to workflows and ensure quality assurance standards are maintained at all times.

• High School Diploma/GED
• Proficient in Windows
  10 and Microsoft Office
• Strong MS Excel and Access skills required
• Ability to work independently and as part of a team with minimal supervision
• Proficient in web tools and technology
• Knowledge of accounting ledgers and balance sheets
• Strong organizational and interpersonal skills; excellent verbal and written communication skills

• Bachelor’s Degree in Accounting, Finance or Business
• Knowledge of Epic EDI related experience
• Medical billing and/or banking experience preferred

Lift and carry 25lbs.
Frequent sitting/standing, frequent keyboard use. Patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

• 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, including 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
• Medical (including prescription) insurance for colleagues, including those who work less than part‑time (including per diem colleagues, adjunct faculty, and Jeff Temps)

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Work Shift:

Workday Day (United States of America)

Primary

Location:

1101 Market, Philadelphia, Pennsylvania, United States of America