Pat Acct Rep IV

Thomas Jefferson University & Jefferson Health
United States, Pennsylvania, Philadelphia
Jan 15, 2025
Job Details ESSENTIAL FUNCTIONS Responsible for totaling, batching and entering into billing system charges for physician activity. Works closely with collection agencies as well as with patients, the practices and all staff regarding collection activities. Sends claims and physician bills to patients and various third-party insurance carriers. Ensures all procedures and diagnosis coding is done appropriately. Ensures all data regarding procedures performed is obtained from physicians. Reviews explanation of benefits received to ensure proper payment from the insurance company. Posts patient and third party payments to accounts in the IDX system. Interacts with co-workers, visitors, and other staff consistent with the core values of the University. OTHER FUNCTIONS AND COMPETENCIES Follows-up rejected or underpaid claims. Remains current and knowledgeable regarding all insurer and regulatory changes (includes Medicare, Medicaid, and all Managed Care Programs with whom department participates). Handles telephone billing inquiries from patient and insurance companies. Handles inquiries from Practice Physicians concerning billing inquiries, work with physicians to insure proper patient account write-off. Reviews and maintains all patient accounts with current insurance coverage. Periodically reviews individual accounts receivables as directed by supervisor. Assists in establishing work priorities, including projects and non-routine assignments. Reviews work for quality and conformance to departmental policy. Assists with training of assigned staff. Reviews claim edit lists for missing or incorrect registration data, diagnostic or procedure codes. Refers edits to practices where appropriate for resolution. Ensures that all necessary documentation is attached to paper claims, incuding operative notes, referrals, EOBs of benefits for secondary insurance and Act 44 (WC) and Act 6 (Auto) reports. Initiates paperwork for patient or third party refunds. Adjusts outstanding balances for contractual adjustments and professional courtesy according to JUP policies and procedures. Handles billing inquiries from patients and third party payors where appropriate. Provides coverage and support to other billing personnel in the JUP Business Services Office as required. Other duties or special projects as assigned. Job Description EDUCATIONAL/TRAINING REQUIREMENTS: Minimum of a high school diploma or GED equivalent required. EXPERIENCE REQUIREMENTS: Minimum of three years of billing experience in a multi-specialty group practice. Current knowledge of third party rules and regulations. Must possess the ability to accurately analyze and identify errors. Demonstrated experience in area of physician coding, billing and registration. Attention to detail is essential. Must have strong service orientation. Work Shift Workday Day (United States of America) Worker Sub Type Regular Primary Location Address 833 Chestnut Street, Philadelphia, 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.