Benefits Overview

Beyond a great professional environment, Abington – Jefferson Health offers a competitive compensation and benefits package to full and part-time employees. A few highlights include medical, dental, sick time, vacation and holiday specialty certifications, discount parking, direct deposit, credit union, on-site childcare and more!

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Job #9246349
Physician Billing Representative
Abington Physicians Network Billing - NWG
Full-Time - Days - 40 Hours/Week
Abington Hospital - Jefferson Health
1200 Old York Road, Abington, PA 19001
Primary Function:
Under the direction of the Revenue Cycle Manager in the Abington Health Physician Billing Office, the Billing Representative is responsible for receivables management of one or more insurance which may include any portions of the billing cycle: the daily batching and electronic submission of all claims, retrieving transmission reports, reviewing all edits, correction of denied claims, reconciling the process, processing payer rejections and doing reconsiderations/appeals while meeting the departments establishe benchmarking standards..

ESSENTIAL FUNCTIONS:
  • Transmits claims on a daily basis. Monitors transmission reports to assure all claims are received and processed accordingly. Completes all payer rejections in a timely manner in accordance with department standards.
  • Runs multiple canned reports, and reviews claims for accuracy. Contacts practice staff if necessary for clarification and make corrections when need to insure the claims will transmit electronically.
  • Performs daily system update function timely. Batches claims according to specific EDI regulation/credentialing status for submission to the clearinghouse. Performs the 72 hour review and moves claims on a weekly basis.
  • Identifies, separates and mails claims that require paper submissions for timely submission.
  • Monitors payer edits and keeps the supervisor informed of any changes in regulations. Monitors provider enrollments to assure that claims correctly to ensure timely reimbursements.
  • Discerns discrepancies in either Explanations of Benefits or claim submissions through maintaining understanding of insurance companies’ rules and regulations.
  • Maintains appropriate proficiency in physician billing systems, as well as proficiency using external computer-generated media to monitor and promote prompt and accurate patient account reimbursement.
  • Reviews, researches and amends correspondence/Explanations of Benefits and makes appropriate adjustments to accounts as per third party regulations.
  • Identifies and communicates possible system and reimbursement problems to facilitate an efficient and accurate review of the payers.

Qualifications:
  • Education and Training: Minimum high school graduate; some college or equivalent work preferred.
  • Experience: Minimum of 2 years of experience in a large physician network environment. Must be proficient in reading and understand third-party remittance advice.
  • Other Requirements: Proficient in the use of Microsoft Office (Word, Excel) and knowledge of various PM systems. Must have a good understanding of CPT and ICD-10 codes.
Abington Hospital – Jefferson Health is an equal opportunity employer, and our policy prohibits discrimination in employment because of race, creed, national or ethnic origin, gender, sexual orientation, age, disability, marital status, or veteran status.
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Benefits Overview

Beyond a great professional environment, Abington – Jefferson Health offers a competitive compensation and benefits package to full and part-time employees. A few highlights include medical, dental, sick time, vacation and holiday specialty certifications, discount parking, direct deposit, credit union, on-site childcare and more!

View more details.