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Hackensack Meridian Health · 10 hours ago

Third Party Follow-Up Analyst

Tinton Falls, NJ

Full-time

Onsite

Entry, Mid Level

$63K/yr - $63K/yr

2+ years exp

Hackensack Meridian Health is dedicated to helping patients lead healthier lives while fostering a supportive work environment for its employees. The Third Party Follow-Up Analyst role involves analyzing accounts receivable data, identifying denial trends, and collaborating with various departments to improve revenue management and prevent future payment issues.

Assisted LivingHealth CareHealth DiagnosticsHospitalMedical

Responsibilities

Identifies and performs root cause analysis of the high volume denials and presents the findings to the Revenue Operations team. Communicates improvement opportunities and corrective action based on findings. When appropriate, bring issues to closure to prevent multiple hand-offs

Performs analytical review of denials to support Patient Financial Services, Case Management, Access, and other departments as it relates to denials. Determines reason for denials, meets with appropriate Revenue Operations leaders, and makes recommendations to prevent future denials

Identifies problems in process workflow and/or changes in payer's billing rules and regulations and governmental guidelines that slows cash flow and disseminates information to management

Collaborates with the Training department on developing education materials based from the resolution /outcome of the improvement opportunities presented at interdisciplinary meetings

Collaborates with Follow-Up Manager in developing process and workflow on trends identified on various areas of operation

Prepares trending reports of all high volume denials within the follow-up department's open accounts receivable. Meets biweekly and monthly with various departments to communicate findings and make recommendations to improve revenue management

SME (Subject Matter Expert) for complex denials and payment variances including contracts, fee schedules, and edits. Educates and provides feedback to various areas on Revenue Operations metrics and key performance indicators

Utilizes and develops new Epic and ad-hoc accounts receivable or denial reporting tools for management, using the current information system and/or other software programs to achieve desired reporting outcomes

Performs reimbursement management and tracks and reports on high volume discrepancies which will be used as escalation to Managed Care, the payer, or IT. Monitors denials and initiates CPT or DRG analysis to determine reason for denial

Monitors daily dashboard and reports and conducts analytical reviews to determine if changes or enhancements on current policies and procedures are required

Participates in meetings with appropriate personnel to exchange ideas on working towards accounts receivable related changes or enhancements and works closely with the Follow-Up Manager to develop required reports for meetings

Conducts accounts receivable audits as defined by SVP, Sr Revenue Officer and Patient Financial Services Managers

Meets bi-weekly and monthly with various vendors and outsource agencies to discuss bottlenecks in revenue flow and discusses solutions. Acts as liaison between agencies and Follow-Up department to prevent accounts receivable aging and ensures timely flow of communication

Monitors account work queues, analyzes trends, and follows up if metrics exceed or fall below baselines

Collaborates with Revenue Operations Analyst and Billing Analyst as needed

Able to perform all Third Party Follow-Up Representative functions/tasks

Other duties and/or projects as assigned

Adheres to HMH Organizational competencies and standards of behavior

Qualification

Healthcare billing experienceEpic proficiencyAnalytical skillsICD-9/10 knowledgeMicrosoft Office SuiteManaged Care knowledgeCommunication skillsTime managementAttention to detailCritical thinking

Required

BA/BS degree in accounting, business, healthcare administration or a related field; or equivalent relevant HMH experience

Minimum of 2 years of experience in a healthcare billing office or health insurance claims environment

Familiar with common medical billing practices, concepts, and procedures

Excellent analytical and critical thinking skills

Ability to work in a fast paced business office

Must be able to coordinate multiple projects with multiple deadlines or changing priorities

Strong attention to details

Proficient with computer applications including Microsoft Office Suite with strong Excel skills/Google Suite

Must be highly organized and possess excellent time management skills

Strong written and verbal communication skills

Knowledge of ICD-9/10 and medical terminology

Must become Epic Credentialed and/or take and pass Epic online Patient Accounting, ADT and Prelude proficiency courses within 6 months of hire and/or promotion

Must be proficient in use and understanding of Third Party Payers Portals

Certification or Proficiency in Epic HB Fundamentals within in 6 months of hire

Certification or Proficiency in Epic HB Insurance Follow-Up within 3 months of hire

Successfully pass completion of EPIC assessment within 30 days after Network access granted