Manager, Specialty Claims and Accounts Receivable

Hackensack Meridian Health • Tinton Falls, NJ • 3h ago

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.

The Manager of Specialty Services, Claims & Accounts Receivable is responsible for overseeing the full spectrum of billing operations and third-party account follow-up across all facilities within the HMH network. This role ensures that pre-billing, billing, and follow-up processes are executed efficiently, accurately, and in compliance with local, state, and federal regulations, as well as organizational revenue cycle goals. Key responsibilities include managing multiple Supervisors, Analysts, and billing team members and providing strategic oversight of claims submission, electronic data interchange (EDI) transactions, and clearinghouse applications. The Manager leads testing and validation efforts for system upgrades, modifications, and regulatory changes, while ensuring timely and accurate claims processing. Additionally, this role directs third-party follow-up activities across all payers including but not limited to HMO, Blue Cross, Commercial, Government, and Managed Care payers, Specialty and Client billing ensuring accounts are resolved promptly and effectively. The Manager collaborates closely with the Vice President and Patient Financial Service (PFS) Directors to identify operational issues, recommend solutions, and implement initiatives that enhance productivity, maximize cash collections, and improve overall revenue cycle performance.

This is a full time position in Patient Financial Services (PFS) - Claims Management overseeing 2 direct reports and approximately 20 team members in total!

This a hybrid role - requires one day per week or as needed for mandatory meetings in Edison NJ.

Education, Knowledge, Skills and Abilities Required:

Bachelor's degree; or equivalent relevant experience at 4 years or more.

Minimum of 5+ years of experience plus prior management experience in healthcare accounts receivable to health insurance receivable environment.

Minimum of three years of Hospital/facility claims experience working in an automated environment.

Excellent communication, interpersonal, and analytical skills.

Ability to work in a fast paced and dynamic environment.

Computer proficiency.

Excellent written and verbal communication skills.

Proficient computer skills that include but are not limited to Google Suite and/or Microsoft Office platforms.

Education, Knowledge, Skills and Abilities Preferred:

MS/MA/MBA degree.

Working knowledge of UB/837i Claim specifications and requirements.

Knowledge of EPIC and/or the Change Healthcare Assurance Claims Scrubber application.

Licenses and Certifications Preferred:

Healthcare Financial Management Association (HFMA), Coding, EPIC or similar certification.

If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!

176252

Minimum rate of $131,144.00 Annually

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.

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