Payment Research Specialist (Revenue Cycle)

Jefferson Health; Elkins Park Gardens (PA); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Medical coverage

Dental insurance

Vision benefits

Retirement plans

Tuition assistance

Job summary

The Payment Research Representative is part of Jefferson Health's Revenue Cycle Enterprise, focusing on proper handling and reconciliation of payments across the system. You will work with Payment Representatives, Accounting and Finance to investigate and resolve cash processing issues.

Day-to-day duties include researching payment discrepancies, reviewing explanations of benefits, and using Navinet/payor portals to ensure accurate postings and timely reconciliations.

Qualifications

• High School Diploma or GED required.
• Strong MS Excel and Access skills.
• Ability to work independently and as part of a team.
• Proficient in web tools and technology.
• Knowledge of accounting ledgers and balance sheets.
• Strong organizational and interpersonal skills; excellent verbal and written communication skills.

Responsibilities

• 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 payor portals to obtain additional information as necessary.
• Utilize online payor portals, such as Navinet, for claims determination, eligibility, offset requests and appeals.
• Applies 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.
• Interprets and validates 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.

Skills

Independent work

Team collaboration

Web tools & technology

Verbal & written communication

Organizational skills

Interpersonal skills

Education

High School Diploma / GED

Bachelor’s Degree in Accounting/Finance/Business

Tools

Windows 10

Microsoft Office

MS Excel

MS Access

Navinet

Job description

The Payment Research Representative is part of Jefferson Health's Revenue Cycle Enterprise, focusing on proper handling and reconciliation of payments across the system. You will work with Payment Representatives, Accounting and Finance to investigate and resolve cash processing issues.

Day-to-day duties include researching payment discrepancies, reviewing explanations of benefits, and using Navinet/payor portals to ensure accurate postings and timely reconciliations.