This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

Responsible for the follow-up with all third party payers, patients and other departments related to outstanding account balances, payment discrepancies and execute resolution.

• 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.
• Maintain understanding of various third-party insurance carriers and regulatory requirements as related to receiving full and proper payments.
• Interact with co-workers, visitors, and other staff consistent with the values of Jefferson.
• Complete account adjustments as required.
• Review correspondence and take appropriate action to expedite resolution of outstanding receivables with established quality/time standards.
• Contact payers regarding unpaid accounts within designated timeframes.
• Maintain productivity and quality requirements as defined by departmental policy.
• Other duties as assigned by supervisor.
• Demonstrated ability to work independently with minimal supervision.

Qualifications

• High School Diploma/GED required
• Associates or Bachelor's degree preferred
• 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

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.