Collection Rep Lead- Home Infusion

Today, Jefferson Health and its network of hospitals and physician practices serve patients throughout the Delaware Valley. We have a robust network of 18 hospitals, 3500 physicians, 9600 nurses, 3,876 licensed beds, and physician practices throughout the counties of:

• Bucks
• Camden
• Gloucester
• Montgomery
• Philadelphia

We are Philadelphia#39;s second largest employer, and nationally ranked by US News amp; World Report in seven specialties including #2 Ophthalmology (Wills Eye), #9 Rehabilitation (MossRehab), #10 in Orthopedics (Rothman Orthopaedics at Jefferson Health, Philadelphia Hand to Shoulder Center, 3B Orthopedics, the Abington Orthopedic amp; Spine). Whether yoursquo;re in the city or the suburbs, Jefferson Health provides the exceptional care you expect ndash; close to home or work ndash; through our broad family of primary care physicians and specialists. Jefferson Health is home to nationally ranked experts who provide a personalized care plan for you. Sidney Kimmel Cancer Center ndash; Jefferson Health is one of only 70 NCI-designated cancer centers in the country. With more than 30,000 employees, we are the largest health system in the Philadelphia region by total licensed beds. And our work to improve lives is never done.

In keeping with Jefferson#39;s Mission, We Improve Lives, it is our goal to recruit, retain, develop and reward highly-qualified employees. If you are enthusiastic, caring and dedicated to service excellence, we invite you to consider joining Jefferson. Jefferson encourages its employees to expand their knowledge and develop their careers through growth opportunities and continuing education.

Culture

We are a creative and collaborative team dedicated to outstanding professional work on behalf of our patients. Our goal is to meet our patients#39; needs and help them advocate for themselves and their family members. We believe our place in the community is as a healer, an activist, and a trusted friend. We perform our duties with empathy and compassion as we serve the needs of the underserved population of North Philadelphia. While we do have an academic component to our work, we strive to be community doctors who take pride in serving others. Join us...make a difference.

007403

PRIMARY RESPONSIBILITIES:

• Serves as the quality assurance component of the Billing and Collections process.
• Ensure the timely and accurate completion of the Home Infusion services, insurance, and patient billing, re-submissions, and cash collection through effective patient, and carrier interaction.
• Resolve disputes in payer reimbursement and patient billing, while identifying all aged accounts, and initiate aggressive follow up through direct or telephone contact and letters.
• Effectively handles multiple, and shifting priorities while meeting time sensitive guidelines.
• Will use a variety of web based tools as a part of achieving departmental goals.
• Requires effective A/R management, documentation, and follow-up to avoid excessive aging of the accounts, and will initiate adjustments when needed.
• Requires the ability to perform complex calculations, dosage and units of measure conversions.
• Perform reimbursement and payment analysis, create and maintain tracking and trending reports, communicates results or issues to payer representatives, and the management team.
• Participates in the strategy and planning for reducing DSO, and denial rates. Will assist management team in staff training and payer in service training.
• Functions as an integral part of the Month End processing, and review of payer outcomes.
• The position includes, but is not limited to the following essential functions.

ESSENTIAL FUNCTIONS:
middot; Review payment, denials, payer contracts, and claim rejections, research and resubmit where appropriate
middot; Verify dosage amounts and units of measure and perform calculations or conversions as required by either the vial size, or the HCPC code in conjunction with the physicianrsquo;s orders
middot; Research and resubmit claims/statements without a payer response within established time frames
middot; Collect patient balances including full payment, deductibles and co-payments
middot; Interacts with co-workers, visitors, and other staff consistent with the core values of the Hospital.

EDUCATIONAL/TRAINING REQUIREMENTS: High school diploma or equivalent. Some college desirable.

CERTIFICATES, LICENSES, AND REGISTRATION: None

EXPERIENCE REQUIREMENTS: Minimum of five years A/R experience, in an electronic healthcare/insurance
billing, or 2-3 years experience in an Infusion billing setting. Familiarity with computer and web based billing and collection
systems, as well as the MS Office Suite of applications. Strong verbal and written communication skills, as well as
demonstrated math skills. Good problem solving skills, and must be detail oriented. Ability to work well independently,
and handle multiple and changing priorities. Familiarity with HIPPA standard codes, and basic understanding of coding
functions. Customer service experience in the patient and healthcare setting.

About Jefferson

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#39;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 educashy;tional 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.