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 Travel Reimbursement and may be eligible to receive a 401(k) match. At www.TeamHMH.com (https://hackensackmeridianhealth.icims.com/proxy/classic-data/classic-data-spa/export/profile/www.TeamHMH.com) , 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.
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 supervisor`s 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 HMH`s 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.
Education, Knowledge, Skills and Abilities Required:
High School diploma, general equivalency diploma (GED), and/or GED equivalent programs
Minimum of two (2) 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 (2) years of Healthcare experience
Associate's degree or higher
173613
Starting at $22.78 Hourly
HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package.
The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to:
Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness.
Experience: Years of relevant work experience.
Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training.
Skills: Demonstrated proficiency in relevant skills and competencies.
Geographic Location: Cost of living and market rates for the specific location.
Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization.
Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered.
Some jobs may also be eligible for performance-based incentives, bonuses, or commissions not reflected in the starting rate. Certain positions may also be eligible for shift differentials for work performed on evening, night, or weekend shifts.
In addition to our compensation for full-time and part-time (20+ hours/week) job positions, HMH offers a comprehensive benefits package, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits.
HACKENSACK MERIDIAN HEALTH (HMH) IS AN EQUAL OPPORTUNITY EMPLOYER
All qualified applicants will receive consideration for employment without regard to age, race, color, creed, religion, sex, sexual orientation, gender identity or expression, pregnancy, breastfeeding, genetic information, refusal to submit to a genetic test or make available to an employer the results of a genetic test, atypical hereditary cellular or blood trait, national origin, nationality, ancestry, disability, marital status, liability for military service, or status as a protected veteran.
