Revenue Cycle Representative II

About the role

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. This is a regular employee position at Albert Einstein Medical Center, located at 60 Township Line Road, Elkins Park, Pennsylvania, with the option to work from home.

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.

Responsibilities

• 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; references payer websites or contacts as needed.
• Maintains understanding of third party regulations for appeals and appeal follow-up.

Requirements

• 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.

Skills

• 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.
• Demonstrated ability to work independently with minimal supervision.
• Perform other duties as assigned by supervisor.

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