Revenue Cycle Lead

Job Details

Job Description

The Lead Enrollment & Revenue Cycle Specialist supports the Revenue Cycle operations by serving as a key resource to staff and assisting supervisory personnel with daily workflow coordination and process oversight. This role combines cash operations leadership with provider enrollment expertise to ensure accurate reimbursement operational efficiency and compliance across the revenue cycle.

Essential Functions

• Interacts with co-workers visitors and other staff consistent with the values of Jefferson.
• Complete and maintain all initial and ongoing provider enrollment applications for commercial and government payers including full oversight of CAQH profiles NPI records and related provider data to ensure accuracy and compliance
• Configure and maintain Electronic Funds Transfer (EFT) Electronic Data Interchange (EDI) and Electronic Remittance Advice (ERA) with payers clearinghouses banking partners and internal systems (including Epic) ensuring accurate electronic data exchange and timely reimbursement.

• Serve as the primary liaison with payers and clearinghouse to initiate and manage enrollment communications monitor payment methods for cost effectiveness and track/report enrollment status using established tracking tools; proactively follow up to resolve delays or discrepancies.

• Support supervisory staff in managing daily departmental operations and workflows driving increased automation in payment processing to enhance efficiency accuracy and alignment with departmental objectives.

• Provide training mentoring and day-to-day guidance to team members; serve as a resource for troubleshooting issues and escalating systemic concerns as needed.

• Assist in the development maintenance and documentation of standard operating procedures (SOPs) to promote operational consistency and efficiency across the revenue cycle team.

Competencies (Knowledge Skills and Abilities Required):

Must demonstrate strong interpersonal organizational and communication skills.

Ability to work independently and as a team member.

Effective problem-solving skills required.

Must be able to meet departmental goals on an ongoing basis.

Experience with revenue cycle applications/systems

Awareness of compliance and regulatory guidelines

Working knowledge of Microsoft Word and Excel.

Knowledge healthcare claims processing and payment workflows

Experience in claims processing

Education:

High School Diploma/Equivalent

AND

Experience:

4 years experience in a healthcare/revenue cycle setting with specific experience in business functions such as; registration follow up denials and payment posting.

Work Shift

Worker Sub Type

Employee Entity

Primary Location Address

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 65000 people strong dedicated to providing the highest-quality compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrows 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 10 colleges and three schools offering 200 undergraduate and graduate programs to more than 8300 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 educational 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.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues including medical (including prescription) supplemental insurance dental vision life and AD&D insurance short- and long-term disability flexible spending accounts retirement plans tuition assistance as well as voluntary benefits which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues including those who work less than part-time(including per diemcolleagues adjunct faculty and Jeff Temps) have access to medical (including prescription) insurance.

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