Revenue Cycle Analyst, Physician Billing Jobs in Hasbrouck Heights at Hackensack Meridian Health

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.

The Revenue Cycle Analyst, Physician Billing provides statistical and financial data enabling management to accurately monitor accounts receivable activity on an ongoing basis. Identifies issues for management regarding significant changes in various accounts receivable categories reflected in the daily dashboards and denial reports. Supports the Revenue Cycle team and Practice Management by monitoring key metrics related to revenue and accelerated cash flow. This position performs high level analysis of accounts receivable and uses considerable judgment to determine solutions to complex problems. All tasks must be performed in a timely and accurate manner. Meets with appropriate Revenue Cycle and Practice Operations leaders and makes recommendations to prevent future denials and payment variances. Disciplines include but are not limited to Patient Accounting, Case Management, Health Information, Clinical, Training, Managed Care, Outsource Partners, Practice Management and IT. Duties performed are at the network level within the Hackensack Meridian Health (HMH) Network.

Responsibilities

A day in the life of a Revenue Cycle Analyst, Physician Billing at Hackensack Meridian Health includes:

• Participates & Reports on Weekly Graph & Workflow meetings on Denials trending for the Network. Identifies and performs root cause analysis of high-volume denials and underpayments, and presents the findings to the Revenue Cycle team. Communicates improvement opportunities and corrective actions based on findings.
• Act as Team Leader to ensure all team members are trained & aligned with established Desktop & policies & procedures.
• Performs analytical review of denials to support Revenue Operations, Case Management, Access, and the various clinical practices as it relates to denials and payment variances. Determines the reasons for denials, meets with appropriate Revenue Cycle leaders and Practice Management, and makes recommendations to prevent future denials and payment variances.
• Identifies problems in process flow or changes in payer's billing rules and regulations and governmental guidelines that create barriers to cash flow, workflows, and informing management.
• Collaborates with the Training department on developing education materials based from the resolutions/outcomes of the improvement opportunities presented at interdisciplinary meetings.
• Collaborates with the Department Manager in developing processes and workflows on trends identified on various areas of operation.
• Prepares trending reports of all high volume denials and payment variances. Meets biweekly and monthly with various departments to communicate findings and recommendations to improve revenue management.
• SME (Subject Matter Expert) for commercial insurance, Medicaid/Medicare, and payer liability guidelines as well as complex denials and payment variances including contracts, fee schedules, and edits. Educates and provides feedback to various areas on Revenue Cycle metrics and key performance indicators.
• Utilizes and develops new Epic and ad-hoc accounts receivable or denial reporting tools (i.e. SlicerDicer, Denials Pulse) to support management decision-making. Leverage integrated information systems and advanced software programs to design reporting tools that achieve specific operational outcomes, drive financial clarity, and improve revenue management.
• Tracks and reports on causes of manual adjustments which will be the basis of escalation to Information Technology for contract management corrections.
• Performs user audits based on manual adjustment reports. Reviews activities to improve the revenue cycle. Ensures that the team is following departmental procedures and are in compliance with governmental and commercial payer guidelines.
• Performs reimbursement management, analyzes payer reimbursement to ensure proper claim adjudication, and tracks and reports on high volume payment discrepancies which will be used as escalation to Managed Care, the payer, or IT. Monitors payments denials and initiates CPT or DRG analysis to determine reasons for denial.
• Conducts analytical reviews of daily dashboards and reports to determine trends and the need for enhancements to existing policies and procedures.
• Schedules, coordinates, and participates in meetings, addressing inquiries with relevant personnel to exchange regarding accounts receivable changes or enhancements. Works in close collaboration with the Department Manager to prepare necessary reports for the meeting.
• Performs accounts receivable audits on the all-payer follow-up workqueue to verify that the backend team operates as intended. Evaluates manual adjustment reports on a monthly basis to determine appropriateness, reporting the outcomes directly to leadership.
• Continuous charge capture monitoring: Daily tracking of unbilled, missing, or delayed charge encounters across the network practices(Open Encounters, Charge Lag reports). Investigating systemic billing errors, provider documentation gaps, work with IT on integration flaws causing dropped charges, and Billing Compliance on charging requirements.
• Partnering with clinical staff, HIM, Coding, IT, Training and billing teams to fix and prevent revenue leakage.
• Supports leadership by preparing data-driven reports and focus reviews, ensuring preparedness for recurring and upcoming Practice Support meetings.
• Develop corrective action plans and optimize workflows to drive proactive process improvements, ensuring accurate and timely charge entry.
• Monitor variance report to determine if rate in Contract Management was loaded correctly or the variance is due to underpayment. Report Contract variance to IT, escalate volume underpayments to payer representative.
• Meets with various vendors and outside agencies to discuss bottlenecks in revenue flow and discusses solutions. Acts as a liaison between agencies, practice management and Reconciliation department to prevent AR aging and timely flow of communication.
• Monitors account work queues, analyzes trends, and follows up if metrics exceed or fall below baselines.
• Manage the Skip Statement work queues to maintain compliance with specialized payer contracts, or to resolve patient complaints regarding erroneous billing.
• Assists with ongoing management of Epic as it relates to physician billing and other Epic enhancements.
• Able to perform all Adjustment Representative functions/tasks and other duties as assigned.
• Other duties and/or projects as assigned.
• Adheres to HMH Organizational competencies and standards of behavior.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• Bachelor's degree or equivalent HMHN work experience.
• Minimum of 4 years of related work experience.
• Strong analytical, mathematical, and report writing skills.
• Microsoft office or Google Workspace: Data organization, document formatting, formula usage, and workflow automation.
• Knowledge of Physician hospital billing systems.
• Thorough knowledge of billing requirements and regulations of major payers.
• Excellent written and verbal communication skills.
• Proficient computer skills that include but are not limited to Google Suite and/or Microsoft Office platforms.

Licenses and Certifications Required:

• Must successfully pass completion of EPIC assessment within 30 days after Network access granted.

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

Compensation
Minimum rate of $73,153.60 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.

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.