Revenue Cycle Representative II

jeffersonhealth; New Jersey; On-site; USD 24,000 - 34,000; Full time

Job summary

Jefferson Health is seeking a Revenue Cycle Representative II to manage payment research, reconcile postings and investigate issues across the Revenue Cycle Enterprise in a fast-paced environment.

The role emphasizes collaboration with Payment Representatives, Accounting and Finance to ensure accurate cash processing and timely resolution of discrepancies. Strong Excel/Access and accounting knowledge are essential.

Qualifications

• 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

• 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.

Skills

MS Excel

Access

Windows 10

Communication

Teamwork

Education

High School Diploma/GED

Bachelor's Degree Accounting/Finance or Business

Tools

Epic

Job description

Job Details

Revenue Cycle Representative II

Job Description

JOB 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.

ESSENTIAL FUNCTIONS

• 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.

QUALIFICATIONS

Education - Required

• High School Diploma/GED

Education - Preferred

• Bachelor's Degree Accounting, Finance or Business

Knowledge, Skills and Abilities - 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

Knowledge, Skills and Abilities - Preferred

• Knowledge of Epic
• EDI related experience
• Medical billing and or banking experience preferred

Salary Range

$17.41 to $24.81 Hourly The actual hiring rate will be determined based on candidate experience, skills and qualifications. This position is not eligible for an annual incentive.

Positions posted as annual salaries reflect an estimated amount for a 1.0 Full-Time Equivalent (FTE) (i.e. 40 hour equivalent)), positions for less than 1.0 FTE will be prorated.)

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular Employee Entity

Kennedy University Hospitals, Inc Primary Location Address

101 Woodcrest, Cherry Hill, New Jersey, 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), su