Rev Cycle Representative II

Rev Cycle Representative II at Jefferson Health

Job Description

Responsible for reviewing, analyzing, and initiating appropriate action for complex case claim denial resolution by communicating with payers, hospital departments, and patients.

Essential Functions

• Interact with co-workers, visitors, and other staff consistent with the values of Jefferson.
• Implement appropriate strategy for effective appeal, including conducting authorization research, rebilling, and balance write‑off or transfer for next responsible party.
• Correspond with third‑party payers, hospital departments, and patients to obtain information required for denial resolution.
• Use reference material to troubleshoot payer issues and increase understanding of denial resolution techniques. Reference payer websites or contact as needed.
• Maintain understanding of third‑party regulations for appeals and appeal follow‑up.

Competencies

• Communicate with patients, insurance carriers, physician’s offices, and other hospital departments in a courteous and professional manner.
• Maintain productivity and quality requirements as defined by department policy.
• Demonstrate ability to work independently with minimal supervision.
• Other duties as assigned by supervisor.

Education and Experience

• High School Diploma/GED required. Associates or Bachelor’s degree preferred.
• Minimum 3 years of experience working in hospital revenue cycle.
• Working knowledge of insurance plans and contract language.
• Computer skills, including proficiency in Windows 10 and Microsoft Office.
• Knowledge of State and Federal healthcare billing and coding guidelines.
• Experience working with Epic preferred.

Work Shift
:
Workday Day (United States of America)

Worker Sub Type
:
Regular

Primary Location
: 2500 Maryland Road, Willow Grove, Pennsylvania, United States of America

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.

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.