Revenue Cycle Payment Research Specialist II

Jefferson Health Plans; Pennsylvania; In loco; USD 42.000 - 64.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical coverage

Dental & vision

Retirement plans

Tuition assistance

Disability coverage

Descrizione del lavoro

Jefferson Health Plans is seeking a Payment Research Representative to support the Jefferson Revenue Cycle Enterprise. The role focuses on proper handling and reconciliation of payments, investigating issues that affect cash posting and balances, and collaborating with Payment Representatives, Accounting, and Finance.

You will review explanations of benefits, communicate with third-party payors, and ensure accurate posting and timely closure of batches.

Competenze

• High School Diploma or GED is required.
• Strong MS Excel and Access skills.
• Ability to work independently and in a team with minimal supervision.
• Proficiency with Windows 10 and Microsoft Office.
• Knowledge of accounting ledgers and balance sheets.
• Excellent verbal and written communication skills.

Mansioni

• Interact with co-workers, visitors, and staff per Jefferson values.
• Identify and resolve payment issues through research and investigation.
• Contact third-party payors or view payor portals for information.
• Use Navinet and other payor portals for claims, eligibility and appeals.
• Post payments and adjustments to patient accounts following third-party rules.
• Validate postings of payments and denials from EOBs.
• Research over-posted or undistributed credits via credit work queues.
• Ensure cash records link to payment batches and batches are reconciled.
• Communicate system or reimbursement issues to supervisor for review.
• Adhere to workflows and maintain QA standards.

Conoscenze

Excel & Access

Accounting basics

Teamwork

Web tools

Communication skills

Microsoft Office

Windows 10 proficiency

Formazione

High School Diploma/GED

Bachelor’s Degree in Accounting/Finance/Business

Strumenti

Epic

EDI systems

Descrizione del lavoro

Jefferson Health Plans is seeking a Payment Research Representative to support the Jefferson Revenue Cycle Enterprise. The role focuses on proper handling and reconciliation of payments, investigating issues that affect cash posting and balances, and collaborating with Payment Representatives, Accounting, and Finance.

You will review explanations of benefits, communicate with third-party payors, and ensure accurate posting and timely closure of batches.