Overview

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

At Hackensack Meridian Health at Home, we recognize our full- and part-time benefit eligible team members by offering a Total Rewards package including comprehensive Health Benefits, generous Paid Time Off, Travel Reimbursement as well as an investment in your future with a 401(k) match and Tuition Reimbursement. Per Diem team members are eligible to participate in the 401(k) match and Travel Reimbursement. At , you'll find the information, resources and tools that will help you to be successful at HMH. From great benefits and innovative wellness programs, to robust learning and development opportunities, we continue to cultivate an exceptional work environment where you can do the kind of work that leads to fulfillment and professional growth.

Responsibilities

Accountable for overall accounts receivable responsibilities including but not limited to billing, posting, collections and account analysis.

• Confirm Delivery Tickets and review associated charges for accuracy.
• Review payer contracts and ensure updates to fee schedules are inputted into the EMR system and activated timely to ensure proper pricing of all charges.
• Process assigned payer billing daily. Generate source reports in EMR system, reviews charges for accuracy and alignment with payer contracted rates to reduce denials. Transmit billing batches electronically via clearinghouse and confirms acceptance of all submitted batches.
• Investigate all billing problems and initiate correction if applicable. Work to resolve billing issues with Medicare, Medicaid and insurance companies. Follow up to ensure corrections are completed.
• Complete posting of payer remittances and patient payments in an accurate and timely manner.
• Complete and process all hard copy denials into the EMR system within 48 hours of receipt.
• Process adjustments timely and with the authorization from the Administrative Manager.
• Process all recertification Certificates of Medical Necessity (CMN) and send them to physicians' offices. Assure CMNs are returned accurately and complete prior to the due date.
• Process requests for all renewal prescription requests to physician offices. Assure all renewal prescription requests are returned accurately and complete prior to due date to reduce held claims for billing.
• Process all reauthorization requests to insurance payer with required medical necessity documentation two weeks prior to current authorization expiration. Assure all reauthorizations are received back to prior to due date (expiration) and inputted into the EMR system.
• Review open AR in EMR system daily and process and work denied claims via appropriate method (appeal, corrected claim, etc.) for resolution as defined by payer provider manual, and prior to expiration of payer timely filing for appropriate resolution method.
• Maintain AR for assigned payer(s) at or below benchmarks and at an appropriate level. Assure DSO is at an acceptable level as indicated by the organization benchmark.
• Review difficult collection issues and work with multiple resources including payer special project teams and internal HMH revenue cycle escalation team to resolve open AR issues timely with payers.
• Complete all matrix reports daily and review with Manager on a weekly basis.
• Maintain and update shared payer coverage documentation to assist Customer Service Department with ensuring referrals meet payer guidelines for coverage. Communicate payer changes to coverage guidelines to Customer Service Supervisor and Customer Service Representatives regularly and timely as necessary.
• Resolve voicemail messages daily. Work on correspondence daily.
• Complete filing and review mail upon supervisors request.
• Answer phone promptly and in a courteous, professional manner. Assure accurate and complete phone messages are taken and relayed to the appropriate party. Interact with patients in a professional manner, explaining any billing questions, and collecting open patient balances.
• Other duties and/or projects as assigned. Demonstrate flexibility with job responsibilities in all areas.
• Adhere to HMHs Organizational competencies and standards of behavior.
• Lift a minimum of 10 lbs., push and pull a minimum of 10 lbs. and stand a minimum of 2 hours a day.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• High School diploma, general equivalency diploma (GED), and/or GED equivalent programs
• Minimum of two years of Billing and Collections experience
• Strong analytical skills
• Strong customer service skills
• Proficiency in Microsoft Office applications and/or Google Suite applications

Education, Knowledge, Skills and Abilities Preferred:

• Two years of Healthcare experience
• Associates degree or higher

Our Network

Hackensack Meridian Health (HMH) is a Mandatory Influenza Vaccination Facility

As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.