Clerk - Financial Services

Clerk- Financial Services

Responsible for administrating the billing to secondary and tertiary payers in alignment with all regulations and hospital policies. Research and respond to inquiries/complaints related to the billing process resolving all elements for processing. Also, responsible for the follow-up with all third-party payers, patients and other departments related to outstanding account balances, payment discrepancies and execute resolution.

Essential Functions:

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
• Processes claims and edits via assigned work queues to ensure third parties have received the information in a timely and accurate fashion.
• Research, make necessary corrections and update accounts ensuring accurate billing
• Remains current on payer plan changes, updates and website in determining benefit eligibility.
• Review and resolve assigned charge review edits.
• 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.
• Resolve claim edits with internal departments
• Update and reconcile adjustments as necessary.
• Analyze and research payment discrepancies. Determine and execute appropriate action for resolution.
• Maintains understanding of various third-party insurance carriers and regulatory requirements as related to receiving full and proper payments.

Competencies (Knowledge, Skills, and Abilities Required):

• Excellent communication skills, as a position requires frequent contact with physician practice staff and insurance representatives.
• Demonstrated ability to work independently with minimal supervision.
• Completes account adjustments as required.
• Reviews correspondence and takes appropriate action to expedite resolution of outstanding receivables with established quality/time standard.
• Contacts payers regarding unpaid accounts within designated timeframes.
• Maintains productivity and quality requirements as defined by departmental policy.
• Other duties as assigned by supervisor.

Minimum Education and Experience Requirements:

• High School Diploma or GED.
• Associates or Bachelors degree preferred.
• 1-2 years of healthcare revenue cycle experience or other related experience required.
• Demonstrated proficiency in mathematics.
• Demonstrated understanding of healthcare terminology, insurance plans and contract language preferred.
• Knowledge of State and Federal healthcare billing guidelines.
• Computer skills, including proficiency in Microsoft Office.
• Knowledge of ICD-10 and CPT coding.

Work Shift: Workday Day (United States of America)

Worker Sub Type: Regular

Primary Location Address: 101 E Olney Ave, Philadelphia, Pennsylvania, United States of America

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.

At Jefferson, we offer a comprehensive total rewards package designed to support the health and well-being of our colleagues and their families. It includes a wide range of benefits including competitive pay, health and retirement benefits, life and disability insurance, paid time off, educational benefits, financial and mental health resources and much more. Our diverse benefits offerings ensure you have the coverage and access to services you need to thrive both personally and professionally.