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Jefferson Health · 2 days ago

REVENUE CYCLE REPRESENTIVE 1

Philadelphia, PA

Full-time

Onsite

Entry Level

2+ years exp

Jefferson Health is a nationally ranked healthcare system dedicated to providing high-quality clinical care and education. The Revenue Cycle Representative I will follow up on insurance claims, ensure timely reimbursement, and maintain knowledge of insurance regulations while working collaboratively within a team.

Hospital & Health Care

Responsibilities

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 supervisor any rejection trends or other issue 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 the University

Qualification

Insurance claims processingICD-10 codingCPT codingEpic billing systemInsurance denial codesThird Party RulesCommunication skillsTeamwork

Required

High School degree 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

Experience in insurance claims processing

Follow-up with insurance payors on rejected or underpaid claims