Revenue Cycle Payment Research Specialist II

Jefferson Health; Philadelphia (Philadelphia County); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Retirement Plan

Tuition Assistance

Group insurance discounts

Job summary

Jefferson Health seeks a Payment Research Representative II to ensure accurate handling and reconciliation of payments across the revenue cycle. You will work with payment representatives, accounting and finance to research issues and resolve payment and posting discrepancies.

Responsibilities include reviewing explanations of benefits, contacting payors, using Navinet and payor portals, and ensuring cash batches are posted and reconciled timely while maintaining QA standards.

Qualifications

• High School Diploma/GED.
• Proficient in Windows 10 and Microsoft Office.
• Strong MS Excel and Access skills required.
• Ability to work independently and as part of a team with minimal supervision.
• Proficient in web tools and technology.
• Knowledge of accounting ledgers and balance sheets.
• Strong organizational and interpersonal skills; excellent verbal and written communication skills.

Responsibilities

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
• Identify and resolve payment issues through research and investigation.
• Review explanation of benefits to confirm payments were applied appropriately.
• Contact third party payors or view payor portals to obtain additional information as necessary.
• Utilize online payor portals, such as Navinet, for claims determination, eligibility, offset requests and appeals.
• Applies payment and adjustments to patient accounts per third party regulations, providing accurate accounts receivable and balance billing while meeting the department’s established productivity benchmarks.
• Interprets and validates transaction postings of payments and denials received from third party explanation of benefits either in the form of batched images or via electronic remittance posting work queues.
• Research over-posted or undistributed credit balances via credit work queues.
• Confirm that cash records are properly linked to associated payment batches prior to posting.
• Communicate possible system and reimbursement issues to the supervisor who will facilitate a review and analysis of the potential impact and confirm best course of action.
• Adhere to workflows and ensure quality assurance standards are maintained at all times.

Skills

MS Excel

Access

Windows 10

Web tools

Accounting ledgers

Balance sheets

Communication skills

Education

Bachelor’s Degree Accounting, Finance or Business

Tools

Epic

EDI

Job description

Jefferson Health seeks a Payment Research Representative II to ensure accurate handling and reconciliation of payments across the revenue cycle. You will work with payment representatives, accounting and finance to research issues and resolve payment and posting discrepancies.

Responsibilities include reviewing explanations of benefits, contacting payors, using Navinet and payor portals, and ensuring cash batches are posted and reconciled timely while maintaining QA standards.