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.

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.

EDUCATIONAL/TRAINING REQUIREMENTS:
High school Diploma or GED

EXPERIENCE REQUIREMENTS:
Minimum 3-5 years experience working in billing within a medical setting

ADDITIONAL INFORMATION:
Knowledge of professional fee billing environment; strong computer skills including those involved in data base and spreadsheet programs, WORD and PowerPoint; familiarity with medical terminology preferred; Working knowledge of Microsoft Office

ESSENTIAL FUNCTIONS:

• 
  Reviews physician submitted outpatient coding. Review ICD-10, CPT and modifiers.
• Ensures timely follow up outstanding A/R to ensure proper cash flow is maintained.
• Identifies barriers to timely claim submissions and payments, recommend corrective action.
• Reviews, investigates, and takes action upon reports such as edit reports, pre-collection reports, rejection reports, etc.; identify patterns and recommend corrective action.
• Interprets and enforces complex policies and procedures related to patient registration, benefit structures, and to third party professional billing.
• Responds to routine information requests, ensures outside offices are properly informed.
• Responds to telephone inquiries from patients and insurance companies regarding billing, coverage criteria, coordination of benefits and subscriber eligibility.
• Interacts with co-workers, visitors, and other staff consistent with the iSCORE values of Jefferson.
• Maintains knowledge of current JUP policies and procedures and customer service standards.
• Respond to a high volume of telephone calls and emails, deal with each independently or triage appropriately.
• Perform a broad range of clerical functions such as faxing, coordinating mass mailings, label creation, copying, etc.
• Obtain prior authorizations and referrals for procedures/office visits when needed.
• Work with physicians and staff to obtain information required for initial claim submission, and for follow-up to edits, denials and rejections.
• Assist physicians and staff to better understand coding, documentation requirements and standards, unbundling, and the appropriate use of modifiers.
• Other duties as assigned.