Rev Cycle Representative I

Health Partners Plans; United States; On-site; USD 42,000 - 68,000; Full time

Benefits offered by this job

Medical insurance

Prescription coverage

Dental

Vision

Life and AD&D insurance

Short- and long-term disability

Flexible spending accounts

Retirement plans

Tuition assistance

Voluntary benefits

Job summary

Jefferson Health Plans in Willow Grove, Pennsylvania, is seeking a billing specialist responsible for administering the billing to secondary and tertiary payers in alignment with regulations and hospital policies. You will research inquiries and complaints related to the billing process and resolve all elements for processing.

Key duties include processing claims via work queues, researching and correcting accounts, staying current on payer plan changes to determine benefit eligibility,

Qualifications

• High School Diploma or GED required.
• At least 2 years of healthcare revenue cycle experience or related experience.
• Knowledge of healthcare terminology.
• Knowledge of state and federal healthcare billing guidelines.
• Proficiency in mathematics.

Responsibilities

• Process claims and edits via assigned work queues to ensure third parties receive information timely and accurately.
• Research, correct, and update accounts to ensure accurate billing.
• Stay current on payer plan changes, updates and websites to determine benefit eligibility.
• Review and resolve assigned charge review edits.
• Interact with coworkers, visitors, and staff in line with Jefferson values.

Skills

Revenue cycle

Healthcare billing

Regulatory knowledge

Mathematics

ICD-10 coding

CPT coding

Education

High School Diploma

Tools

EPIC

Job description

Number of Positions In Requisition

1

Job Details

Responsible for administering the billing to secondary and tertiary payers in alignment with all regulations and hospital policies. Research and respond to inquiries/complaints related to the billing process resolving all elements for processing.

Job Description

Summary

Responsible for administering the billing to secondary and tertiary payers in alignment with all regulations and hospital policies. Research and respond to inquiries/complaints related to the billing process resolving all elements for processing.

Job Duties

• Processes claims and edits via assigned work queues to ensure third parties have received the information in a timely and accurate fashion.
• Research, make necessary corrections and update accounts ensuring accurate billing.
• Remains current on payer plan changes, updates and website in determining benefit eligibility.
• Review and resolve assigned charge review edits.
• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.

Minimum Qualifications

• High School Diploma/GED
• 2 years healthcare revenue cycle experience or related experience
• Knowledge of healthcare terminology
• Knowledge of State and Federal healthcare billing guidelines
• Demonstrated proficiency in mathematics

Preferred Qualifications

• Bachelor's Degree or
• Master's Degree
• experience working with EPIC
• experience in telecommuting
• Knowledge of IDC-10 and CPT coding

Physical Demands

Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

Job Description Disclaimer

This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Abington Memorial Hospital Primary Location Address
2500 Maryland Road, Willow Grove, Pennsylvania, United States of America

Company Overview

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.

Equal Opportunity Statement

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

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.