Revenue Cycle Representative II

Job Details

Revenue Cycle Representative II

Job Description

    

The Revenue Cycle Representative II is responsible for ERA and EFT enrollment to ensure accurate reimbursement, operational efficiency, and compliance across the revenue cycle.

Essential Functions

· Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.

· Provide and maintain W‑9 documentation for payers upon request to support payer enrollment, contractual requirements, and timely reimbursement.

· Review and maintain Electronic Funds Transfer (EFT), Electronic Data Interchange (EDI), and Electronic Remittance Advice (ERA) with payers, clearinghouses, banking partners, and internal systems (including Epic), ensuring accurate electronic data exchange and timely reimbursement.

· Assist with payers and clearinghouse to initiate and manage enrollment communications, monitor payment methods for cost effectiveness, and track/report enrollment status using established tracking tools; proactively follow up to resolve delays or discrepancies.

· Research payer capabilities and enroll live check via Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) where available to support electronic payment optimization and efficiency.

· Assist in the maintenance, and documentation of standard operating procedures (SOPs) and enrollment playbook to promote operational consistency and efficiency across the revenue cycle team.

Competencies (Knowledge, Skills, and Abilities Required):

Must demonstrate strong interpersonal, organizational, and communication skills.

Ability to work independently and as a team member.

Effective problem-solving skills required.

Must be able to meet departmental goals on an ongoing basis.

Experience with revenue cycle applications/systems

Awareness of compliance and regulatory guidelines

Working knowledge of Microsoft Word and Excel.

Knowledge healthcare claims processing and payment workflows

Experience in claims processing

Education:

High School Diploma/Equivalent

AND

Experience:

4 years’ experience in a healthcare/revenue cycle setting with specific experience in business functions such as; registration, follow up, denials, and payment posting.

Work Shift

Rotating (United States of America)

Worker Sub Type

Regular

Employee Entity

Abington Memorial Hospital

Primary Location Address

2500 Maryland Road, Willow Grove, 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.

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