Remote Payment Research Specialist II

Jefferson Health; Philadelphia (Philadelphia County); Remote; USD 42,000 - 63,000; Full time

Job summary

Jefferson Health is seeking a Payment Research Representative to ensure proper handling and reconciliation of payments across the Revenue Cycle Enterprise. You will work with Payment Representatives, Accounting, and Finance to investigate and resolve issues impacting cash processing and reconciliation.

Responsibilities include researching payment discrepancies, reviewing EOBs, contacting payors, using Navinet and other portals, and ensuring accurate postings and timely closings.

Qualifications

• High School Diploma or GED required.
• Strong MS Excel and Access; proficient in Windows 10 and MS Office.
• Ability to work independently and with minimal supervision.
• Familiar with web tools and technology; knowledge of accounting ledgers and balance sheets.
• Excellent verbal and written communication; strong organizational 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

MS Office

Excel

Access

Windows 10

Communication

Education

High School Diploma/GED

Tools

Epic

Navinet

Job description

Jefferson Health is seeking a Payment Research Representative to ensure proper handling and reconciliation of payments across the Revenue Cycle Enterprise. You will work with Payment Representatives, Accounting, and Finance to investigate and resolve issues impacting cash processing and reconciliation.

Responsibilities include researching payment discrepancies, reviewing EOBs, contacting payors, using Navinet and other portals, and ensuring accurate postings and timely closings.