Campus Pride Jobs

Reference #: 9308846 PRIMARY FUNCTION: This position will be responsible for the management of all complex billing, analysis, and revenue/billing for the Department of Radiation Oncology technical and professional billing across TJUH, Aria and other JUP locations. Incumbent will insure all federal regulations and policy amp; procedures are adhered to with respect to auditing, billing, coding, amp; documentation of compliant medical necessity. In depth knowledge of clinical operations and front end patient registration is required. This position will review, audit and recommend revisions to department billing policy and procedures as needed.

ESSENTIAL FUNCTIONS: Ensures accurate and timely billing of all hospital and professional charges, reviews all billing to ensure that charges are consistent with medical necessity documentation; services are rendered and meet all compliance requirements. Works with physicians and staff to obtain information required for initial claim submission, and for follow-up to edits, denials and rejections while managing the charge capture process and quality assurance in working with the Radiaiton Oncology team. Obtains prior authorizations for procedures when needed. Manages billing denials. Follows up on each denial to determine if cause was physician related, system related, or billing error. Eliminate the causes of denials and collect the maximum on each patient account as rapidly as possible. Ensures all diagnosis and procedures that may impact the facilityrsquo;s reimbursement are identified based on accepted diagnostic coding guidelines attested to by the physician, sequenced correctly and coded in an accurate and ethical manner for optimum reimbursement. Consults with physicians and nurse managers for clarifications of clinical data when encountering conflicting or ambiguous information and/or missing documentation. Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson Process billing of daily code captures. Includes coordination of the daily operations and work flow processes while managing billing edits/denials. Responsible for working Quality Assurance Check Lists implemented by Physics and Dosimetry staff to insure the accurate collection and capture of charges. Adjust work assignments as necessary to keep billing lag to a minimum. Daily Charge reconciliation. Keep up-to date with Mosaiq /EMR system upgrades that effect workflows related to billing and documentation. Respond to telephone inquiries from patients and insurance companies regarding billing, coverage criteria, coordination of benefits and subscriber eligibility. Assist Director with monthly Collection Report. Assist Director with developing and implementing procedures to streamline billing process and improve efficiency of process. Cover other positions within the department when needed. High School diploma or GED required. Associates degree preferred 5 or more years of experience in the area of billing operations Word, excel, NaviNet, EviCore etc. Must have knowledge of CPT and ICD-10 coding. Up-to-date knowledge of third-party rules and regulations. Knowledge of medical terminology. 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 0 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.

As an employer, the Jefferson Enterprise 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.