Revenue cycle representative

Health Partners Plans; United States; On-site; USD 52,000 - 65,000; Full time

Benefits offered by this job

Medical insurance

Dental

Vision

Life insurance

Disability insurance

Retirement plan

Tuition assistance

Job summary

Jefferson Health Plans seeks a Billing Specialist to administer billing to secondary and tertiary payers in line with regulations and hospital policies. You will research inquiries, resolve billing questions, and ensure accurate processing of claims and edits.

Responsibilities include handling payer updates, ensuring benefit eligibility accuracy, and maintaining consistency with Jefferson's values while interacting with staff and external partners.

Qualifications

• 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.

Responsibilities

• 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.

Skills

Healthcare revenue cycle experience

Healthcare terminology knowledge

State and Federal healthcare billing

Mathematics proficiency

Education

High School Diploma/GED

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.

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.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Thomas Jefferson University Primary Location Address
201 Old York Road, Jenkintown, Pennsylvania, United States of America

Company Culture

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, which provide colleagues with access to group rates on insurance and discounts
• tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service
• medical (including prescription) insurance available to all colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps)