Revenue Cycle Representative

Job Details

Revenue Cycle Representative I Follow - Up

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 needed 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

Primary Location Address

615 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, an