Third Party Follow-Up Representative


HMH HOSPITALS CORPORATION Hackensack Requisition # 2019-73653 ShiftDay StatusFull Time with Benefits Weekend WorkNo Weekends Required HolidaysNo Holidays Required On CallNo On-Call Required Shift HoursDay Address60 Second Street, Hackensack, 07601

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Overview

How have you impacted someone’s life today?  At Hackensack Meridian Health our healthcare 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 Third Party Follow-up Rep performs follow-up procedures on unpaid third party accounts.

Responsibilities

1. Performs account analysis to ascertain the required follow-up procedure.

2. Researches suspended/pending claims and transfers information to the payer.

3. Prepares report for payer for large volume of outstanding claims.

4. Reports collection efforts/issues for high dollar accounts to management at monthly meetings.

5. Processes third party vouchers and verifies accuracy and timeliness of payment.

6. Reconciles managed care payments to the explanation of benefits to determine patients' responsibility and performs comparison to managed care contract for accuracy.

7. Initiates aging reports by financial class in order to identify problematic areas and accelerate cash flow.

8. Resubmits claims to payers via hard copy, fax, or electronic medium.

9. Contacts physician offices and/or patient and other hospital departments to secure the appropriate information (referrals, notifications, pre-authorizations, and any other required documentation for the payer) in order to process the claim.

10. Adheres to the standards identified in the Medical Center's Organizational Competencies.

Qualifications

Education, Knowledge, Skills and Abilities Required:

1. High school diploma or equivalent.

Our Network

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.