Revenue Cycle Associate I: Payer & Patient Resolutions

Health Partners Plans; Philadelphia (Philadelphia County); On-site; USD 36,000 - 52,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Retirement plans

Tuition assistance

Job summary

Jefferson Health Plans is seeking a Revenue Cycle Representative I in Philadelphia to manage follow-up on outstanding balances with third-party payers, patients, and internal departments. The role focuses on resolving unpaid or denied accounts and ensuring timely, accurate payments.

Primary responsibilities include contacting payers and departments to obtain necessary information, resolving claim edits, and researching discrepancies to drive resolution in a compliant manner.

Qualifications

• Epic Proficient
• Commercial and Multiplan Payer Knowledge
• Understanding of payer requirements and denials processes

Responsibilities

• Follow-up with payers regarding unpaid or denied accounts.
• Contact third-party payers, hospital departments, and patients to obtain information required for account resolution.
• Resolve claim edits with internal departments and update adjustments as necessary.
• Analyze and research payment discrepancies to determine appropriate resolution actions.
• Communicate within designated timeframes to expedite outstanding receivables.

Skills

Epic Proficient

Commercial and Multiplan Payer Knowl

Education

High School Diploma/GED

Associates or Bachelors

Job description

Jefferson Health Plans is seeking a Revenue Cycle Representative I in Philadelphia to manage follow-up on outstanding balances with third-party payers, patients, and internal departments. The role focuses on resolving unpaid or denied accounts and ensuring timely, accurate payments.

Primary responsibilities include contacting payers and departments to obtain necessary information, resolving claim edits, and researching discrepancies to drive resolution in a compliant manner.