[Hiring] Revenue Cycle Representative II @Jefferson Health Plans
Role Description
Revenue Cycle Representative II is responsible for reviewing, analyzing and initiating appropriate action for complex case claim denial resolution by communicating with payers, hospital departments and patients.
- Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
- Completes appropriate strategy for an effective appeal including conducting authorization research, rebilling, and balance write off or transfer for next responsible party.
- Corresponds with third party payers, hospital departments, and patients to obtain information required for denial resolution.
- Uses reference material to troubleshoot payer issues and increase understanding of denial resolution techniques. Reference payer websites or contact as needed.
- Maintains understanding of third party regulations for appeals and appeal follow-up.
- Demonstrated ability to work independently with minimal supervision.
- Other duties as assigned by supervisor.
Qualifications
- High School Diploma/GED required.
- Associates or Bachelors degree preferred.
- Minimum 3 years of experience working in hospital revenue cycle.
- Working knowledge of insurance plans and contract language.
- Computer skills, including proficiency in Windows 10 and Microsoft Office.
- Knowledge of State and Federal healthcare billing and coding guidelines.
- Experience working with Epic preferred.
Requirements
- Communicate with patients, insurance carriers, physician’s offices, and other hospital departments in a courteous and professional manner.
- Maintains productivity and quality requirements as defined by department policy.
Benefits
- 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.
- 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.
