• Follow-Up on billed claims to third party insurance carriers within the initial payer filing guidelines
• Accountable for resolving all claims denials, and meeting or exceeding daily/weekly/monthly productivity targets set forth by management
• Maintains a complete understanding of the Accounts Follow-Up functions and required software programs
• Utilizes SMS, Cerner, Artiva modules and all other EHN software systems in accordance with Patient Financial Services and/or EHN protocols
• Develops and maintains a working knowledge of payer contracts, contractual requirements, particularly initial claim filing periods and claims denial codes information in addition to other payer’s information needed to resolve denied and/or underpaid claims
• Works with Follow-Up Supervisor to develop and implement follow up workflows to resolve denials and/or claims underpayments within payer’s filing period time
• Reviews claim denials information to identify trends and preventable root cause issues, and communicates these to the follow up Supervisor
• Establishes effective relationships with other follow up representatives
• Addresses/resolves issues relating to patient accounts
• Meets productivity and quality measurement standards as set forth by the Manager
• Addresses denial write-offs in accordance with the EHN Adjustment Approval Policy
• Makes decisions in an ethical/effective/sound manner, adheres to corporate compliance/risk management/safety standards, displays an open-minded attitude, establishes priorities, conceptualizes and organizes time and resources to accomplish the job
• Uses creativity/innovation in carrying out responsibilities/introducing new ideas or programs; adapts traditional methodologies in accordance with a changing business environment
• Stays current with All Commercial/HMOs Payers, Medicare and Medicaid regulations applying such to day-to-day operations of the department in order to maintain corporate compliance. Is knowledgeable of managed care contractual arrangements and Jefferson-EHN charity policies
• Responsible for exercising regular and punctual attendance; complies with Jefferson-EHN policies regarding absenteeism and tardiness
• Adheres to Jefferson-EHN confidentiality policy which includes verbal, written, computer generated, computer accessed, filmed and recorded information related to patients, their family and visitors, staff, physicians, and clients. Responsible for the protection of confidentiality of data at all times.
• Works in a safe manner and follows all EHN safety requirements. Reports all incidents, near misses, and adverse events
• Performs other duties as required

• 2 years Facility Billing experience preferred
• Invision SMS/ GE Flowcast software experience preferred
• High school diploma or GED equivalent required

Covid Vaccination is a requirement for employment at Jefferson for employees working at Jefferson’s clinical entities or at the University. If you are not currently vaccinated you will be required to receive the vaccination prior to hire date if you are offered employment, unless you request and receive an approved medical or religious exemption from Jefferson.

Jefferson includes Thomas Jefferson University and Jefferson Health, a dynamic university and health system with broad reach across the Delaware Valley. Jefferson is the second largest employer in Philadelphia and the largest health system in Philadelphia based on total licensed beds.

Through the merger of Thomas Jefferson University and Philadelphia University in 2017, our University includes ten colleges and four schools. We are an NCAA Division II university and an R2 national doctoral university offering undergraduate and graduate-level programs that provide students with a forward-thinking education in architecture, business, design, engineering, fashion and textiles, health, medicine and social science.

Jefferson Health, the clinical arm of Thomas Jefferson University, has grown from a three-hospital academic health center in 2015, to an 18-hospital health system through mergers and combinations that include hospitals at Abington Health, Aria Health, Kennedy Health, Magee Rehabilitation and Einstein Healthcare Network. We have over 50 outpatient and urgent care centers; ten Magnet®-designated hospitals (recognized by the ANCC for nursing excellence); the NCI-designated Sidney Kimmel Cancer Center (one of only 70 in the country and one of only two in the region); and one of the largest faculty-based telehealth networks in the country. In 2021, Jefferson Health became the sole owner of HealthPartners Plan, a not-for-profit health maintenance organization in Southeastern Pennsylvania. We are the first health system regionally to create an aligned payer-provider partnership.

Jefferson’s mission, vision and values create an organization that attracts the best and the brightest students, faculty, staff, and healthcare professionals, as well as the most visionary leaders to drive exceptional results.

• OUR MISSION: We improve lives.
• OUR VISION: Reimagining health, education and discovery to create unparalleled value
• OUR VALUES: Put People First, Be Bold & Think Differently and Do the Right Thing

As an employer, Jefferson maintains a commitment to provide equal access to employment. Jefferson values diversity and encourages applications from women, members of minority groups, LGBTQ individuals, disabled individuals, and veterans.