Revenue Cycle Representative II

Jefferson Health; Jefferson Center (PA); Remote; USD 42,000 - 60,000; Full time

Job summary

Jefferson Health is seeking a Payment Research Representative to ensure proper handling and reconciliation of payments within the Revenue Cycle Enterprise. The role collaborates with Payment Representatives, Accounting and Finance to investigate and resolve cash processing issues.

The position requires strong MS Excel/Access skills, attention to detail, and the ability to work independently or as part of a team to maintain accurate accounts receivable and timely posting of batches.

Qualifications

• High School Diploma or GED required.
• 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

• Interact with coworkers, visitors, and other staff consistent with the values of Jefferson.
• Identify and resolve payment issues through research and investigation.
• Review explanations of benefits to confirm payments were applied appropriately.
• Contact third party payors or view payor portals to obtain additional information.
• 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 productivity benchmarks.
• Interprets and validates transaction postings of payments and denials from third party explanation of benefits.
• 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.
• Ensure that batches are posted, reconciled, closed and processed timely and accurately.
• Communicate possible system and reimbursement issues to the supervisor for review.
• Adhere to workflows and ensure QA standards are maintained.

Skills

Strong communication

Organizational skills

Teamwork

Attention to detail

Independent worker

Education

High School Diploma/GED

Bachelor’s Degree in Accounting/Finance/Business

Tools

Windows 10

Microsoft Office

MS Excel

Access

Job description

Remote Summary

The Payment Research Representative is responsible for proper handling and reconciliation of payments received throughout the Jefferson Revenue Cycle Enterprise. Working closely with Payment Representatives, Accounting and Finance, the Payment Research Rep will investigate and resolve issues impacting cash processing and reconciliation.

Job Duties

• 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.
• Ensure that batches are posted, reconciled, closed and processed timely and accurately.
• 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.

Minimum 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

Preferred Qualifications

• Bachelor’s Degree Accounting, Finance or Business
• Knowledge of Epic EDI related experience
• Medical billing and or banking experience preferred

Work Shift

Workday Day (United States of America) Worker Sub Type Regular Employee Entity Thomas Jefferson University Primary Location Address 1101 Market, 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.