Rev Cycle Representative I

Jefferson Health; United States; On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Retirement plans

Tuition assistance

Flexible spending accounts

Job summary

Jefferson Health is seeking a Revenue Cycle Representative I to manage follow-up with third-party payers, patients, and internal departments for outstanding balances and payment discrepancies. The role requires effective communication and independent work to meet deadlines and quality standards.

Responsibilities include contacting payers about unpaid/denied accounts, resolving edits, updating adjustments, and researching discrepancies to drive timely payments.

Qualifications

• Epic Proficient with Commercial and Multiplan Payer knowledge.
• Strong payer follow-up and denials resolution skills.
• Ability to analyze and resolve payment discrepancies.

Responsibilities

• Follow up with third-party payers, patients, and departments on outstanding balances.
• Contact payers regarding unpaid or denied accounts.
• Obtain information required for account resolution (unpaid/denied accounts, payment variances).
• Resolve claim edits with internal departments.
• Update and reconcile adjustments as necessary.
• Analyze and research payment discrepancies to determine resolution actions.
• Communicate with payers within designated timeframes to expedite resolution.

Skills

Epic Proficient

Payer Knowledge

Education

High School Diploma/GED

Associates or Bachelors

Job description

Number of Positions In Requisition 1 Job Details Revenue Cycle Representative I Job Description

Job Summary Responsible for the follow-up with all third-party payers, patients, and other departments related to outstanding account balances, payment discrepancies, and executing resolution.

Essential Functions

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
• Contact payers regarding unpaid or denied accounts.
• Contact third-party payers, hospital departments, and patients to obtain information required for account resolution, i.e., unpaid, denied accounts, payment variances, etc.
• Resolve claim edits with internal departments.
• Update and reconcile adjustments as necessary.
• Analyze and research payment discrepancies. Determine and execute appropriate action for resolution.
• Contacts payers regarding unpaid accounts within designated timeframes.
• Maintains understanding of various third-party insurance carriers and regulatory requirements as related to receiving full and proper payments.
• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
• Maintains productivity and quality requirements as defined by departmental policy.
• Demonstrated ability to work independently with minimal supervision.
• Reviews correspondence and takes appropriate action to expedite resolution of outstanding receivables with established quality/time standards.

Competencies (Knowledge, Skills, and Abilities Required)

Epic Proficient Commercial and Multiplan Payer Knowledge

Education

High School Diploma/GED required Associates' or Bachelors Work Shift Workday Day (United States of America) Worker Sub Type Regular Employee Entity Thomas Jefferson University Hospitals, Inc.

Primary Location Address 601 Walnut Street, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years. 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

• 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, which provide colleagues with access to group rates on insurance and discounts.
• Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.
• All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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In keeping with Jefferson's Mission, We Improve Lives, it is our goal to recruit, retain, develop and reward highly-qualified employees. If you are enthusiastic, caring and dedicated to service excellence, we invite you to consider joining Jefferson. Jefferson encourages its employees to expand their knowledge and develop their careers through growth opportunities and continuing education. With a long standing history, Jefferson has been advancing the medical field from the heart of Center City Philadelphia for nearly 200 years. Our Mission, We Improve Lives, expands to every corner of the organization. From our weekly farmer’s market, to our new Jefferson Accelerator Zone for innovation, our employees’ passion for the community is evident by the daily gestures towards our patients, students and each other.