Revenue Cycle Representative II

Thomas Jefferson University & Jefferson Health; Jenkintown (PA); On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

Medical Insurance

Tuition Assistance

Retirement Plans

Job summary

Jefferson Health’s Payment Research Representative role focuses on accurate handling and reconciliation of payments within the Jefferson Revenue Cycle Enterprise. You will work with Payment Representatives, Accounting and Finance to investigate and resolve payment-related issues.

Responsibilities include reviewing EOBs, querying third-party payors, posting payments and adjustments, and ensuring batches reconcile and post timely. Strong Excel/Access and communication skills are required.

Qualifications

• High School Diploma or GED required.
• Strong MS Excel and Access skills.
• Ability to work independently and in a team with minimal supervision.
• Knowledge of accounting ledgers and balance sheets.
• Excellent verbal and written communication skills.

Responsibilities

• Interacts with staff to identify and resolve payment issues through research.
• Review explanations of benefits to confirm payments were applied correctly.
• Contact third party payors or view payor portals for information as needed.
• Utilize payor portals (e.g., Navinet) for determinations and appeals.
• Apply payments and adjustments to patient accounts per third party rules.

Skills

MS Excel

Access

Windows 10

Organizational skills

Verbal & written communication

Education

High School Diploma or GED

Bachelor’s in Accounting/Finance/Business

Tools

Navinet

EpicEDI

Job description

Number of Positions In Requisition1Job DetailsThe 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 DescriptionSummaryThe 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 DutiesInteracts 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 QualificationsHigh School Diploma/GEDProficient 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 supervisionProficient in web tools and technologyKnowledge of accounting ledgers and balance sheetsStrong organizational and interpersonal skills; excellent verbal and written communication skillsPreferred QualificationsBachelor’s Degree Accounting, Finance or BusinessKnowledge of EpicEDI related experienceMedical billing and or banking experience preferredPhysical DemandsLift 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.Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.Work ShiftWorkday Day (United States of America)Worker Sub TypeRegularEmployee EntityAlbert Einstein Medical CenterPrimary Location Address8250 Old York Road, Jenkintown, Pennsylvania, United States of AmericaNationally 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.BenefitsJefferson 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 medical (including prescription) insurance.