Rev Cycle Representative I bei Jefferson Health

Job Details

Revenue Cycle I Representative

Job Description

PRIMARY FUNCTION:  This position will follow-up with insurance payors on rejected or underpaid claims, initiate claim reviews and work open claims in a timely manner to maximize reimbursement.

                                                                         

ESSENTIAL FUNCTIONS:

• Follow-up with insurance payors on rejected or underpaid claims.  Initiate claim reviews where appropriate.
• Work open claims in a timely manner to maximize reimbursement.
• Resubmit claims to insurance payors with appropriate modifications.
• Ability to understand insurance denial codes and take corresponding action to resolve the denial.
• Knowledge of insurance registration and ability to use payor websites to verify patient eligibility. 
• Remain current and knowledgeable regarding insurance payors rules and regulations such as Medicare, Medicaid, BC/BS and commercial carriers.
• Ability to meet weekly productivity standards established for all staff.
• Identify and report to Manager any rejection trends or other issues that affect reimbursement.
• Experience with Epic follow-up system or other automated follow-up system that requires documentation of actions.
• Good communications skills as position requires frequent contact with physician practice staff and insurance payor representatives. 
• Flexibility to work in a team environment and to accept special projects. 
• Interacts with co-workers, visitors, and other staff consistent with the core values of Jefferson.
• Other duties assigned.

EDUCATIONAL/TRAINING REQUIREMENTS:

High School or GED equivalent required

Willing to train college graduates

Two to three years accounts receivable/billing experience in a physician practice, hospital or ancillary medical billing office.  Will also consider experience in insurance claims processing.

Preferred knowledge of third-party rules and regulations.

Knowledge of ICD-10 and CPT coding preferred.

Experience in Epic billing system highly desirable

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Jefferson University Physicians

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

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