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.
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Contact payers regarding unpaid or denied accounts.
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Contact third party payers, hospital departments, and patients to obtain information required for account resolution, i.e. unpaid, denied accounts, payment variances, etc.
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Resolve claim edits with internal departments.
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Update and reconcile adjustments as necessary.
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Analyze and research payment discrepancies. Determine and execute appropriate action for resolution.
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Maintain understanding of various third-party insurance carriers and regulatory requirements as related to receiving full and proper payments.
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Interact with co-workers, visitors, and other staff consistent with the values of Jefferson.
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Complete account adjustments as required.
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Review correspondence and take appropriate action to expedite resolution of outstanding receivables with established quality/time standards.
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Contact payers regarding unpaid accounts within designated timeframes.
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Maintain productivity and quality requirements as defined by departmental policy.
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Other duties as assigned by supervisor.
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Demonstrated ability to work independently with minimal supervision.
Qualifications
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High School Diploma/GED required; Associates or Bachelor's degree preferred.
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1-2 years of healthcare revenue cycle experience required.
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Demonstrated understanding of healthcare terminology, insurance plans and contract language preferred.
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Ability to communicate clearly (both written and verbal).
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Computer skills, including proficiency in Windows 10 and Microsoft Office.
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Demonstrated proficiency in mathematics.
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Knowledge of State and Federal healthcare guidelines and regulations.
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Experience working with Epic preferred.
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Strong organizational and interpersonal skills; excellent verbal and written communication skills.
Benefits
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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.
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Access to voluntary benefits, which provide colleagues with access to group rates on insurance and discounts.
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Tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service.
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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.