REVENUE CYCLE REPRESENTIVE 1

Job Details Revenue Cycle I Representative Job Description 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 stablished 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. EDUCATIONAL/TRAINING REQUIREMENTS: High School degree or GED equivalent required; Willing to train college graduates. CERTIFICATES, LICENSES, AND REGISTRATION: EXPERIENCE REQUIREMENTS: 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. For more benefits information, please click here In keeping with Jefferson's Mission, We Improve Lives, it is our goal to recruit, retain, develop and reward highly-qualified employees. If you are enthusiastic, caring and dedicated to service excellence, we invite you to consider joining Jefferson. Jefferson encourages its employees to expand their knowledge and develop their careers through growth opportunities and continuing education. With a long standing history, Jefferson has been advancing the medical field from the heart of Center City Philadelphia for nearly 200 years. Our Mission, We Improve Lives, expands to every corner of the organization. From our weekly farmer’s market, to our new Jefferson Accelerator Zone for innovation, our employees’ passion for the community is evident by the daily gestures towards our patients, students and each other.