Revenue Cycle Denials Specialist II

Jefferson Health Plans; Pennsylvania; On-site; USD 42,000 - 58,000; Full time

Job summary

Jefferson Health Plans in Willow Grove, PA seeks a Revenue Cycle Representative II to review and resolve complex claim denials by coordinating with payers, hospital departments and patients. This role requires attention to detail and strong communication.

Candidates should have 3+ years in hospital revenue cycle, knowledge of payer contracts, and proficiency in Epic and Microsoft Office. High school diploma required; associates preferred.

Qualifications

• Experience in hospital revenue cycle and payer communications.
• Experience with Epic is preferred but not always required.
• Proficiency with Windows 10 and Microsoft Office applications.

Responsibilities

• Reviews and initiates actions for complex claim denial resolution.
• Communicates with payers, hospital departments and patients.
• Researches authorizations, rebilling, balance write-offs or transfers.
• Maintains understanding of third-party regulations for appeals.

Skills

Communication

Independent work

Customer service

Payer knowledge

Education

High School Diploma/GED

Associates or Bachelors preferred

Tools

Epic

Microsoft Office

Windows 10

Job description

Jefferson Health Plans in Willow Grove, PA seeks a Revenue Cycle Representative II to review and resolve complex claim denials by coordinating with payers, hospital departments and patients. This role requires attention to detail and strong communication.

Candidates should have 3+ years in hospital revenue cycle, knowledge of payer contracts, and proficiency in Epic and Microsoft Office. High school diploma required; associates preferred.