Newtown Square, Pennsylvania

Main Line Health, with over 11,000 employees and 2000physician practices, is suburban Philadelphia's most comprehensive health careresource, offering a full range of medical, surgical, obstetric, pediatric,psychiatric and emergency services. We are composed of five hospitals, amedical research institute, physician practices and other specializedfacilities and services. Main Line Health is committed to the highest standardsof patient care, education and research. MainLine Health has achieved numerous honors and awards and has been nationallyrecognized by Press Ganey, Truven Analytics, The Joint Commission and otherhealth care ratings organizations for its high quality patient care. We havereceived Magnet® designation by the American Nurses Credentialing Center(ANCC), the nation’s highest award for recognizing excellence in nursing care. At Main Line Health, we have made it our mission toprovide patients with a superior patient experience. This translates to theconsistent delivery of safe, high quality clinical care in the absence ofpreventable harm.

Turn your job into a career by joining Main Line Health!

TheRevenue Cycle Lead (Medicare- facility based) is responsible for using the Epic Billing system, review andfollow up on unpaid, underpaid or rejected insurance accounts with debitbalances in a timely and accurate manner.

  • Provide Epic AR follow up training support tonew and existing team members

  • Serves as first line of contact for accountreceivable representatives regarding any claims issues acting as subject matterexpert and reports trends/issues to Supervisor/Manager.

  • Maintain Epic AR follow up Policy and ProcedureManual and ensure updates are made as workflows change.

  • Assume responsibilities of team members (jobfunctions) in their absence.

  • Work with supervisor and manager to identifyEpic insurance processing related issues and modify strategies for increasingclaim payments and improving overall departmental efficiency.

  • Utilizing Epic workqueues, identify claimsrequiring Follow up.

  • Follow upwith third party payers within payer specified timeframes to ensure timely andproper reimbursement.

  • Document allactivity in Epic for billing, follow up and reporting purposes.

  • Identifyclaims requiring initial or rebilling and take the appropriate workqueue actionto start the billing process.

  • Processappeals to payers for reconsideration of denied claims or partially paidclaims.

  • Keep currenton reimbursement terms/conditions, departmental procedures and applicable payer, Stateand/or Federal guidelines.

  • Identify andreport payer specific trends resulting in incorrect reimbursement by monitoringrejected claims and underpayments.

  • Identify andreport internal system issues resulting in incorrect reimbursement and/orcontractual adjustments.

  • Identify and report to internal departmentsissues/trends by monitoring accounts in various AR follow up workqueues.

Education & Experience(Required):

  • High School Diploma or equivalent
  • Microsoft Office applications experience. Intermediate Excelproficiency required

  • Strong analytical, mathematical andorganizational skills

  • 3+ years billing/cash/accountsreceivable experience utilizing automated patient accounting systems (EpicResolute desirable)

  • Knowledge of insurance contracts, billing regulations andmedical terminology

  • Knowledge of HCPCS/CPT/ICD-10 and revenue codes
  • Certified Revenue Cycle Specialist (CRCS)
  • American Association of Healthcare Administrative Management(AAHAM)

  • Certified Revenue Cycle Representative (CRCR)
  • Healthcare Financial ManagementAssociation

Why Work for Main Line Health?

We arecommitted to providing exceptional care with empathy and compassion for peopleat all stages in life. Our Diversity, Respect and Inclusion Initiativecelebrates our differences and our similarities. Ultimately, we want everyoneto feel respected for who they are. MainLine Health has consistently been ranked among the best places to work by Best Places to Work in PA and the PhiladelphiaBusiness Journal. We also rank among Modern Healthcare's top 100 places in the nation to workin health care. Our physicians and employees speak highly of the workenvironment at Main Line Health

We offer competitivecompensation and outstanding comprehensive benefits including tuitionreimbursement, 403B matching savings plan, a pension plan, and a generous paidtime off program. To be considered, pleaseapply online with your resume at Enter Job ID 52662in Keyword search box.

Applicants must certify that they have not used tobacco productsor nicotine in any form in the 90-days prior to submitting an application toMain Line Health. This will be verified during pre-employment testing. We arean Equal Opportunity Employer. Please, no agency calls.

Ellis Preserve (ELS)
Main Line Health
Ellis Preserve
NewtownSquare, 19073

Newtown Square, Pennsylvania

About Main Line Health


Founded in 1985, Main Line Health (MLH) is a not-for-profit health system serving portions of Philadelphia and its western suburbs.

At its core are four of the region’s respected acute care hospitals—Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital—as well as one of the nation’s premier facilities for rehabilitative medicine, Bryn Mawr Rehab Hospital; Mirmont Treatment Center for drug and alcohol recovery; and Main Line Health HomeCare & Hospice, a home health service. Main Line Health also consists of Main Line HealthCare, one of the region’s largest multi-specialty physician networks, and the Lankenau Institute for Medical Research, a non-profit biomedical research organization located on the campus of Lankenau Medical Center. Main Line Health also consists of four outpatient health centers located in Broomall, Collegeville, Exton and Newtown Square.

Main Line Health hospitals, with more than 10,000 employees and 2,000 physicians, are the recipients of numerous awards for quality care and service, including System Magnet® designation, the nation’s highest honor for nursing excellence. Main Line Health is among the area’s leaders in medicine, providing advanced patient-centered care, education and research to help our community stay healthy.

Similar jobs