Remote Revenue Cycle Specialist II - Denials & Appeals

Jefferson Health Plans; United States; Remote; USD 52,000 - 73,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Retirement plans

Job summary

Jefferson Health Plans is seeking a Revenue Cycle Representative II to review and resolve complex claim denials by coordinating with payers, hospital departments and patients. The role emphasizes appeals research, rebilling, and balance transfers to the next responsible party.

Ideal candidates have 3+ years in hospital revenue cycle, familiarity with insurance plans, and proficiency in Epic and Microsoft Office. This remote, US-based position supports a national network.

Qualifications

• 3+ years of experience in hospital revenue cycle
• Experience with insurance plans and contract language is preferred
• Experience with Epic is preferred and Microsoft Office proficiency

Responsibilities

• Interacts with payers, hospital departments and patients to resolve denials.
• Develops appeals strategies including authorization research and rebilling.
• Communicates with third party payers and departments to obtain denial information.
• Maintains understanding of third party regulations for appeals and follow-up.
• Works independently to meet department productivity and quality standards

Skills

Payer communications

Denial appeals

Independence

Customer service

Communication

Education

High School Diploma/GED

Associates or Bachelors degree preferred

Tools

Epic

Microsoft Office

Job description

Jefferson Health Plans is seeking a Revenue Cycle Representative II to review and resolve complex claim denials by coordinating with payers, hospital departments and patients. The role emphasizes appeals research, rebilling, and balance transfers to the next responsible party.

Ideal candidates have 3+ years in hospital revenue cycle, familiarity with insurance plans, and proficiency in Epic and Microsoft Office. This remote, US-based position supports a national network.