Revenue Cycle Representative I

Jefferson Health Plans; United States; Remote; USD 42,000 - 54,000; Full time

Job summary

Jefferson Health Plans seeks a Revenue Cycle Representative I to manage follow-up on outstanding balances with third party payers, patients, and internal departments. You will work to resolve denials, variances, and payment issues, ensuring accurate and timely payments.

The role requires 1–2 years of healthcare revenue cycle experience, strong communication, and proficiency in Microsoft Office; Epic experience is preferred. Telecommuting is eligible.

Qualifications

• Clear written and verbal communication.
• 1–2 years of healthcare revenue cycle experience.
• Strong mathematical proficiency.

Responsibilities

• Contact payers regarding unpaid or denied accounts.
• Obtain information for account resolution from payers, departments and patients.
• Resolve claim edits with internal departments.
• Update and reconcile adjustments as necessary.
• Analyze and research payment discrepancies and take action.

Skills

Communication skills

Mathematics

Verbal and written clarity

Education

High School Diploma/GED

Associate's or Bachelor's degree preferred

Tools

Windows 10

Microsoft Office

Epic

Job description

Number of Positions In Requisition

1

Job Details

Revenue Cycle Representative I

Job Description

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 COMPETENCIESneeded in addition to Essential Functions:

• 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 diemcolleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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