Revenue Cycle Representative I

Health Partners Plans; United States; Remote; USD 40,000 - 55,000; Full time

Benefits offered by this job

Telecommuting eligible

Job summary

Health Partners Plans is seeking a Revenue Cycle Representative I to follow up with third-party payers, patients, and departments to resolve outstanding balances and payment variances. The role involves contacting payers on unpaid/denied accounts, gathering needed information, and reconciling adjustments.

Ideal candidates have 1–2 years in healthcare revenue cycle, knowledge of healthcare terminology, and strong communication skills.

Qualifications

• High School Diploma or GED required; associates or bachelor's degree preferred.
• 1–2 years of healthcare revenue cycle experience preferred.
• Knowledge of healthcare terminology, insurance plans and contract language helpful.
• Ability to communicate clearly (written and verbal).
• Proficiency in Windows 10 and Microsoft Office; Epic experience preferred.

Responsibilities

• Contact payers regarding unpaid or denied accounts.
• Gather information from payers, departments and patients for account resolution.
• Resolve claim edits with internal departments.
• Update and reconcile adjustments as needed.
• Analyze and research payment discrepancies and determine resolution actions.
• Maintain understanding of third-party carriers and regulatory requirements.
• Demonstrate independence with minimal supervision.

Skills

Payer follow-up

Payment discrepancies

Account resolution

Interdepartmental communication

Healthcare terminology

Education

High School Diploma/GED

Associates or Bachelor's degree preferred

Tools

Epic

Microsoft Office

Windows 10

Job description

Number of Positions In Requisition: 1

Job Details

Revenue Cycle Representative I

Job Description

PRIMARY FUNCTION : Responsible for the follow‑up with all third party payers, patients and other departments related to outstanding account balances, payment discrepancies and execute resolution.

ESSENTIAL FUNCTIONS

• Contact payers regarding unpaid or denied accounts.
• Contact third party payers, hospital departments, and patients to obtain information required for account resolution, i.e. unpaid, denied accounts, payment variances, etc....
• Resolve claim edits with internal departments.
• Update and reconcile adjustments as necessary.
• Analyze and research payment discrepancies. Determine and execute appropriate action for resolution.
• Maintains understanding of various third‑party insurance carriers and regulatory requirements as related to receiving full and proper payments.
• Interacts with co‑workers, visitors, and other staff consistent with the values of Jefferson.

OTHER FUNCTIONS AND COMPETENCIES

• Completes account adjustments as required.
• Reviews correspondence and takes appropriate action to expedite resolution of outstanding receivables with established quality/time standards.
• Contacts payers regarding unpaid accounts within designated timeframes.
• Maintains productivity and quality requirements as defined by departmental policy.
• Other duties as assigned by supervisor.
• Demonstrated ability to work independently with minimal supervision.

EDUCATIONAL/TRAINING REQUIREMENTS

High School Diploma/GED required Associates or Bachelor's degree preferred

EXPERIENCE REQUIREMENTS

• 1-2 years of healthcare revenue cycle experience required
• Demonstrated understanding of, healthcare terminology, insurance plans and contract language preferred.
• Ability to communicate clearly (both written and verbal)
• Computer skills, including proficiency in Windows 10 and Microsoft Office
• Demonstrated proficiency in mathematics
• Knowledge of State and Federal healthcare guidelines and regulations
• Experience working with Epic preferred

ADDITIONAL INFORMATION

Strong organizational and interpersonal skills; excellent verbal and written communication skills. Position is eligible for telecommuting (work from home).

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Thomas Jefferson University Hospitals, Inc. Primary Location Address 833 Chestnut Street, Philadelphia, Pennsylvania, United States of America

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.

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

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps ), have access to medica