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Company

RWJBarnabas Health · 6 hours ago

Associate Analyst ARS, Appeals, Remote, NJ

Oceanport, NJ

Full-time

Remote

Entry Level

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Responsibilities

Analyzes and researches denials, follows-up with the payer to resolve denials

Reviews applicable timeframes governing the appeal process

Contacts appropriate third party for outcome of clinical appeal

Evaluates appeal outcome for next steps (logs recovered funds, supports uphold decision or initiates 2nd level appeal)

Documents accurately and timely the follow-up requirement on denials

Maximize utilization of Contract Management tools and efficient use of existing resources to support cash collection activities

Exercise judgment pertaining to highly sensitive and confidential information

Understanding of claims processing

Demonstrated ability to work independently and on a team as the situation demands

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Medical TerminologyMicrosoft ExcelCommercial InsuranceClaims ProcessingMicrosoft OfficeQuality Improvement

Required

Associate's degree in business or finance preferred

Proficient in medical terminology and knowledge of commercial insurance

Average Microsoft Excel skills required

Microsoft Excel

Microsoft Office

Medical Terminology

Confidentiality - adheres to patient rights: provides for the confidential treatment of all communications and records.

Professionalism - demonstrates professionalism with families, visitors, physicians, co-workers and supervisors.

Communication - listens and communicates effectively

Teamwork - supports teamwork by cooperative problem solving through participation in meetings, projects, etc.

Quality/ Performance Improvement - utilizes principles of continuous quality improvement in all work situations to assess, measure and improve organizational and department functions

Autonomy - organizes work sets priorities with a minimum of supervision and seeks guidance as appropriate

Accountability - makes decisions that are timely and consistent with department, objectives, policies and procedures.

Ownership - demonstrates sound judgment; accepts and benefits from constructive criticism

Analyzes and researches denials, follows-up with the payer to resolve denials

Reviews applicable timeframes governing the appeal process

Contacts appropriate third party for outcome of clinical appeal

Evaluates appeal outcome for next steps (logs recovered funds, supports uphold decision or initiates 2nd level appeal)

Documents accurately and timely the follow-up requirement on denials

Maximize utilization of Contract Management tools and efficient use of existing resources to support cash collection activities

Exercise judgment pertaining to highly sensitive and confidential information

Understanding of claims processing

Demonstrated ability to work independently and on a team as the situation demands

Benefits

Paid Time Off (PTO)

Medical and Prescription Drug Insurance

Dental and Vision Insurance

Retirement Plans

Short & Long Term Disability

Life & Accidental Death Insurance

Tuition Reimbursement

Health Care/Dependent Care Flexible Spending Accounts

Wellness Programs

Voluntary Benefits (e.g., Pet Insurance)

Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!

Company

RWJBarnabas Health

Glassdoor

3.4

RWJBarnabas Health (RWJBH) is the largest, most comprehensive academic health care system in N.J., with a service area covering eight counties with five million people.

Founded in 2020