Manager, Third-Party Follow-up, North
How have you impacted someone’s life today? At Hackensack Meridian Health our teams are focused on changing the lives of our patients by providing the highest level of care each and every day. From our hospitals, rehab centers and occupational health teams to our long-term care centers and at-home care capabilities, our complete spectrum of services will allow you to apply your skills in multiple settings while building your career all within New Jersey’s premier healthcare system.
The Manager, Third Party Follow-Up for the Northern/Central region of the Hackensack Meridian Health (HMH) network directly manages, through proper planning and delegation, the HMO, Blue Cross/Commercial and Government payers' third-party follow-up. Responsibilities include managing the day to day activities of multiple Supervisors and Analysts in addition to approximately 20 team members to ensure accounts are collected and resolved timely in accordance with established departmental goals and objectives.
A day in the life of Manager, Third Party Follow-Up at Hackensack Meridian Health includes:
- Monitors third party follow-up reports and conducts analytical reviews to determine where additional emphasis needs to be placed to ensure the goal of timely and proper follow up is accomplished, per assigned facility/facilities.
- Utilizes weekly follow up system generated work-list reports as a tool for measuring staff performance and identifying areas of improvement.
- Sets productivity standards for staff and supervisors and monitors productivity for compliance.
- Develops guidelines for prioritizing work activities and collection activities.
- Gathers and analyzes information to improve the quality and quantity of work processed.
- Establishes and implements a system for the follow up on delinquent accounts.
- Reviews policies and processes to ensure payers' compliance requirements are met.
- Reviews aging's in accounts receivable, escalates any issues, performs adjustments and coverage updates on self-pay transfers and runs reports for outside vendors.
- Reconciliation files are run to confirm accuracy of data.
- Reviews and resolves HMO, Blue Cross, and Government insurance disputes.
- Ensures requests for information and medical records are handled properly and timely.
- Solves difficult payment and associated follow-up problems.
- Audits problem accounts.
- Runs Workbench reports to trace aged receivables, as needed.
- Supervises, trains, and orients assigned personnel.
- Evaluates performance, promotions and disciplinary actions.
- Maintains knowledge of and complies with established policies and procedures.
- Assists in recruiting and hiring activities for follow-up personnel.
- Attends required meetings and participates in committees as requested.
- Responsible for coordinating the functions necessary for a productive Revenue Cycle meeting.
- Responsible for obtaining and identifying constructive data to be presented in the Denial Management meeting.
- Tracks payer reports on a monthly basis for partial and non-payment activities.
- Meets with payers to discuss how to facilitate faster payments and solve discrepancies.
- Collaborates with HIM manager and CDM coordinator on coding and charging processes.
- Collaborates with Ambulatory Registration in reducing denials.
- Manages quarterly Medicare credit balance report.
- Participates in monthly meeting with Finance to discuss high dollar allowances.
- Participates in the IT meetings to discuss methods and new processes of automation.
- Coordinates and designs educational programs of third-party follow-up staff with training manager.
- Other duties and/or projects as assigned.
- Adheres to HMH Organizational competencies and standards of behavior.
Education, Knowledge, Skills and Abilities Required:
- Bachelor's degree.
- Minimum of 5 or more years of experience plus prior management experience in healthcare accounts receivable to health insurance receivable environment.
- Extensive knowledge regarding Medicare and Medicaid regulation and third-party follow-up rules and guidelines.
- Computer literate. Proficient in various PC software including Microsoft Word and Excel.
- Excellent communication, interpersonal, and analytical skills.
Education, Knowledge, Skills and Abilities Preferred:
- MBA in finance or MPA in Healthcare Administration.
- Knowledge of EPIC.
Licenses and Certifications Preferred:
- Healthcare Financial Management Association (HFMA) - Certified Healthcare Financial Professional (CHFP) Certification.
If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!
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.