Top 157 Claims representative Jobs in Philadelphia, Pa

Revenue Integrity Analyst - Epic Revenue Cycle Analyst, Hybrid, Mt. Laurel
Virtua Health —Mount Laurel, NJ
- $70,935 - $110,268 a year
- Full-time
- Hybrid work
- Research
- Mid-level
- 3 years
- AD&D insurance
- Disability insurance
Service Rep Claim Initiation
Lincoln Financial —Radnor, PA
- $20.10 - $27.41 an hour
- Overtime
- Remote
- Research
- Mid-level
- High school diploma or GED
- Tuition reimbursement
- Paid time off
3d
AR Representative
Penn Medicine —Bala-Cynwyd, PA
- 8 hour shift
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- Tuition reimbursement
Quick Apply
Billing Representative for Infusion - Perelman Center for Advanced Medicine, FT
Penn Medicine —Philadelphia, PA
- Full-time
- Medical office experience
- Mid-level
- High school diploma or GED
- Tuition reimbursement
Quick Apply
9d
Billing Representative
Trident Care —Horsham, PA
- $18 an hour
- Remote
- Microsoft Excel
- Computer literacy
- 3 years
Claims Representative
Penn Lumbermens Mut Ins Co —Philadelphia, PA
- Spanish
- Writing skills
- Mid-level
Claim Examiner
A-G Specialty Insurance, LLC —Berwyn, PA
- $50,000 a year
- Weekends as needed
- Remote
- Mid-level
- Bachelor's degree
- Travel
Senior Claims Specialist I
Liberty Mutual —Bala-Cynwyd, PA
- $67,000 - $126,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- 3 years
10d
ESIS Claims Representative, AGL
Chubb —Philadelphia, PA
- Full-time
- Mid-level
- 3 years
- Communication skills
9d
REVENUE CYCLE REPRESENTIVE 1
Thomas Jefferson University and Hospitals —Philadelphia, PA
- Full-time
- Bachelor of Science
- Medical office experience
- Mid-level
- AD&D insurance
- Disability insurance
4d
Claims - Field Claims Representative
The Cincinnati Insurance Companies —Wilmington, DE
- $60,500 - $99,000 a year
- Day shift
- Mid-level
- Driver's License
- Bachelor's degree
- Paid time off
- 401(k) matching
Patient Account Billing Rep I
Thomas Jefferson University and Hospitals —Philadelphia, PA
- Full-time
- Mid-level
- Office
- Master's degree
- AD&D insurance
- Disability insurance
4d
Financial Service Rep
Penn Medicine —Philadelphia, PA
- Microsoft Word
- Surgery
- Mid-level
- Tuition reimbursement
Quick Apply
9d
Corporate Claims Representative
Teknion, LLC —Mount Laurel, NJ
- Full-time
- Hybrid work
- Mid-level
- Office
- High school diploma or GED
Quick Apply
5d
Revenue Cycle Representative II
Thomas Jefferson University and Hospitals —Willow Grove, PA
- Full-time
- Microsoft Word
- Hospital
- Research
- AD&D insurance
- Disability insurance
Revenue Cycle Representative
Southern Jersey Family Medical Centers —Marlton, NJ
- $21.00 - $24.50 an hour
- Full-time
- High school diploma or GED
- Computer skills
- 1 year
- Paid holidays
- Health insurance
Account Specialist III
Moove NA Distribution Holdings, Inc. —King of Prussia, PA
- $40,000 - $55,000 a year
- Full-time
- Hybrid work
- Microsoft Word
- Background check
- Computer literacy
- Health savings account
- Health insurance
Quick Apply
Specialist, FHA Claims
Freedom Mortgage —Marlton, NJ
- Full-time
- Remote
- Word processing
- Mid-level
- Analysis skills
Authorization Representative
Thomas Jefferson University and Hospitals —Abington, PA
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
- AD&D insurance
- Disability insurance
Senior Complex Commercial Property Claims Adjuster
ICW Group —Philadelphia, PA
- $90,559.93 - $152,723.07 a year
- Full-time
- Remote
- Research
- Bachelor's degree
- Mentoring
- Paid holidays
- Health insurance
12d

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Revenue Integrity Analyst - Epic Revenue Cycle Analyst, Hybrid, Mt. Laurel

Virtua Health -
Mount Laurel, NJ

Apply Now

Job Details

Full-time
$70,935 - $110,268 a year

Benefits

AD&D insurance
Disability insurance
Health insurance
Dental insurance
401(k)
Flexible spending account
Tuition reimbursement
Paid time off
Employee assistance program
Vision insurance
403(b)
Life insurance
Paid sick time

Qualifications

Presentations for conferences or internal meetings
Bachelor's degree
Cross-functional collaboration
Hospital experience

Full Job Description

Job ID: R1057037 Type: Full Time Location: Mount Laurel, New Jersey Standard Hours: 40 Shift: 1st Shift

The following experience is strongly preferred:

EPIC
Hospital charge description master experience
Charge audits
Coding & billing guidelines

Schedule:

Monday-Friday 8:30am - 5:00pm

First 90 days, Monday through Thursday onsite, and Friday remote.

Upon successful training, hybrid 2 days onsite and 3 days remote.

Local onsite meeting requirements.

Job Summary:

The position is responsible for root cause analytics along with audits to help identify opportunities, issues, and process improvement within the Revenue Cycle. This role supports the revenue cycle workflows, charge capture, work queue and denial review processes within an Epic based EMR.

This position will help optimize Revenue Cycle by evaluating, validating and trending data for presentation to all levels of the organization. Will support the Virtua Hospitals, Physician Groups and Home Health.

Position Responsibilities:

Perform quantitative and financial analysis along with audits designed to identify opportunities for improvement across the full spectrum of the Revenue Cycle.

Assists in ensuring that the charge master and fee schedules are in accordance with government compliance policies and procedures, as well as third party payor needs. Review, identify, and analyze necessary CPT changes related to quarterly and annual AMA CPT updates and regulatory changes by timelines set. Works with revenue producing departments to ensure the ongoing coordinated consistency of the charge master and fee schedules, including accurate descriptions, coding, additions, deletions, pricing, and any other changes. Conduct analytical reviews determine net revenue effect of proposed charge master and fee schedule changes. Perform internal billing audits to ensure correcting coding/billing regulatory compliance and charge capture accuracy.

Incumbent must develop close working relationships with management and staff in Revenue Integrity, Finance, Information Technology and Revenue and Clinical Operations allowing them to perform deep-dive analysis and reviews assisting with the identification of trends, solutions and potential corrective action steps. Will work both independently and have a high level of self-directed work efforts as well as be an integral part of the Revenue Integrity Team. Revenue Cycle will include areas from Hospital, Physician and Home Health.

Monitor and assists with review of revenue cycle work queues in Epic. Perform analysis to identify issues, trending, root cause, and action plan development with work queue issues.

Assist in strategic pricing process to optimize reimbursement within budget guidelines. Participate in ongoing coordination and resolution of revenue issues as they arise. Assists in troubleshooting and resolving issues related to the patient revenue cycle and assists in development and recommendations.

Provide guidance and communication and collaborate with Revenue Integrity Team, Clinical Operations and IT to help ensure work queue rules are accurate and updated based on annual and quarterly coding changes.

Assist with Epic performance reporting, including assisting with Revenue & Usage, Enterprise Charge Reconciliation and Volume Reports. Work queue and reporting will include areas from Hospital, Physician and Home Health.

Serve as resource to Patient Financial Services staff for reporting problems and denials on individual claims. Assist in researching coding issues, provide guidance and recommend solution to account representative.

Analyze billing errors and denial data to identify root cause of issues. Work with Revenue Integrity Team, Clinical Operations and Patient Financial Services staff to implement corrective actions to ensure compliant charges, prevent future rejections/denials and accurate and reimbursement. Claim issues and denials will include areas from Hospital, Physician and Home Health.

Lead and participate in projects related to Revenue Cycle initiatives. Participate in ongoing coordination and resolution of revenue issues as they arise. Provide input to Director and Manager for annual Revenue Integrity planning process. Assist with additional projects as needed for Hospital, Physician and Home Health.

Position Qualifications Required:

Required Experience:

3 to 5 years' experience within a large hospital or integrated healthcare delivery system.

Ability to work collaboratively across disciplines and business lines.
Exceptional oral/written communication skills and highly customer focused.
Excellent interpersonal and presentation skills.
Able to communicate with many, various customers.
Ability to prioritize, plan and execute.
Excellent critical thinking, analytical skills.

Required Education:

Bachelor's degree, in Accounting, Finance, Healthcare preferred

Training / Certification / Licensure:

EPIC Revenue Integrity, Hospital Billing, Physician Billing Certification, preferred #RD_P1

Annual Salary: $70,935 - $110,268 The actual salary/rate will vary based on applicant’s experience as well as internal equity and alignment with market data.

Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to: medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, colleague and dependent life insurance and supplemental life and AD&D insurance; tuition assistance, and an employee assistance program that includes free counseling sessions. Eligibility for benefits is governed by the applicable plan documents and policies.

Apply Now

Refine Your Search

claims representative jobs in philadelphia, pa

Revenue Integrity Analyst - Epic Revenue Cycle Analyst, Hybrid, Mt. Laurel

Service Rep Claim Initiation

AR Representative

Billing Representative for Infusion - Perelman Center for Advanced Medicine, FT

Billing Representative

Claims Representative

Claim Examiner

Senior Claims Specialist I

ESIS Claims Representative, AGL

REVENUE CYCLE REPRESENTIVE 1

Claims - Field Claims Representative

Patient Account Billing Rep I

Financial Service Rep

Corporate Claims Representative

Revenue Cycle Representative II

Revenue Cycle Representative

Account Specialist III

Specialist, FHA Claims

Authorization Representative

Senior Complex Commercial Property Claims Adjuster

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