• Investigate, appeal, and resolve denied or rejected claims by insurance payors. • Work with insurance companies to clarify discrepancies and ensure proper reimbursement. • Review and assess Explanation of Benefits (EOBs) at the claim level to determine issues. • Determine root cause of any billing related or claim submission issues to prevent recurrence. • Make corrections to claims based on denials and rebill utilizing standardized process and procedures. • Follow up with unresolved claims through system resources, clearinghouse, payer portal or call to the payor, when necessary. • Assess whether an appeal is required for a claim denial. • Track appeals to ensure timely payment and resolution. • Spot recurring patterns in denials and report them to management for further analysis and action. • Effectively communicate both verbally and in writing with team members, payors, patients, and other relevant parties. • Keep up to date with internal processes, industry standards, and government regulations relevant to denial management to ensure compliance and best practices.

• Enter monthly invoices, debit notes, and credit notes into accounting system • Process deposits against the appropriate customers and accounts • Balance deposits in the accounting system • Follow systems of checks and balances • Allocate broker commissions for payment • Answer internal and external customer calls • Update customer-related information in accounting system • Identify and resolve problems in timely manner • Follow up on delinquent accounts and own accountability for open items • Collect and post claim payments against monthly invoices in accounting system • Enter and process monthly fee claims for ancillary product offerings via claim system • Process advanced accounting entries, such as reclasses, debits & credits

Role Description Responsible for administering the billing to secondary and tertiary payers in alignment with all regulations and hospital policies. Research and respond to inquiries/complaints related to the billing process resolving all elements for processing. - Processes claims and edits via assigned work queues to ensure third parties have received the information in a timely and accurate fashion. - Research, make necessary corrections and update accounts ensuring accurate billing. - Remains current on payer plan changes, updates and website in determining benefit eligibility. - Review and resolve assigned charge review edits. - Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson. Qualifications - High School Diploma/GED - 2 years healthcare revenue cycle experience or related experience - Knowledge of healthcare terminology - Knowledge of State and Federal healthcare billing guidelines - Demonstrated proficiency in mathematics Requirements - Bachelor’s Degree or Master’s Degree - Experience working with EPIC - Experience in telecommuting - Knowledge of IDC-10 and CPT coding Physical Demands - Lift and carry 25 lbs. - Frequent sitting/standing - Frequent keyboard use - Patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR. Benefits - 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. - 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 diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

Role Description We are sharing a specialised part-time consulting opportunity for United States-based healthcare revenue cycle professionals experienced in: - Accounts receivable follow-up - Payer collections - Claim status inquiry - Payer correspondence - Reimbursement resolution - Denial-related follow-up - Revenue recovery workflows This role supports current and upcoming remote consulting opportunities focused on: - AI-assisted accounts receivable workflow evaluation - Payer follow-up content review - Claim status resolution assessment - High-quality project execution Selected professionals will apply revenue cycle expertise to: - Evaluate AI-generated follow-up recommendations - Review payer correspondence drafts - Identify payment or claim resolution issues - Provide structured feedback based on detailed project criteria Qualifications - 5+ years of experience in accounts receivable follow-up, payer collections, revenue cycle operations, or healthcare claims resolution - At least 2 years of experience in a management, team lead, supervisor, or operational oversight role - Deep knowledge of claim status follow-up workflows, EDI 276/277 transactions, payer portals, and payer-specific collections processes - Strong understanding of Medicare, Medicaid, commercial payer, and managed care claims processing timelines - Experience prioritizing and managing high-volume accounts receivable queues across multiple payers - Proficiency with billing systems, accounts receivable management platforms, and revenue cycle workflow tools - Exceptional written and verbal English communication skills - High attention to detail and ability to identify payment errors, payer discrepancies, and issues in AI-generated accounts receivable content Requirements - Professional background in healthcare revenue cycle operations, accounts receivable follow-up, payer collections, billing operations, denial follow-up, claims resolution, or healthcare business office functions - Experience in hospital, physician group, health system, payer-facing, or multi-payer revenue cycle environments - Practical experience with billing systems, payer portals, claim status tools, accounts receivable workqueues, and reimbursement workflows - Formal education in healthcare administration, business, finance, health information management, accounting, or a related field Benefits - Apply accounts receivable follow-up and payer collections expertise to structured remote healthcare project work - Contribute to high-quality AI-assisted revenue cycle workflow evaluation - Use claim status, payer communication, queue prioritization, and reimbursement resolution knowledge in a focused review environment - Work on flexible assignments aligned with healthcare revenue cycle, payer follow-up, and claim resolution expertise - Remote structure with competitive hourly compensation Contract Details - Independent contractor role - Fully remote with flexible scheduling - United States-based professionals are required for this opportunity - Part-time project-based commitment depending on availability, onboarding status, and project needs - Competitive rates of up to $55 per hour depending on accounts receivable follow-up experience, payer collections background, management experience, and project scope - Weekly payments via Stripe or Wise - Projects may be extended, shortened, or adjusted depending on scope and performance - Work will not involve access to confidential or proprietary information from any employer, client, or institution About the Platform This opportunity is available through 24-MAG LLC. We connect experienced professionals with remote consulting opportunities across technical, evaluation, and project-based workstreams. By submitting this application, you acknowledge that your information may be processed by 24-MAG LLC for recruitment and opportunity matching in accordance with our Privacy Policy: Privacy Policy .