Third Party Follow-Up Analyst

Third Party Follow-Up Analyst

Our team members are the heart of what makes us better. At Hackensack Meridian Health (HMH) 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 Third Party Follow-Up Analyst provides statistical and financial data enabling management to accurately monitor accounts receivable activity on an ongoing basis for the Hackensack Meridian Health (HMH) network. Identifies issues for management regarding significant changes in various accounts receivable categories reflected in the daily dashboards and denial reports. Supports the Revenue Operations team 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 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, and IT.

Responsibilities

A day in the life of a Third Party Follow Up Analyst with Hackensack Meridian Health includes :

• Identifies and performs root cause analysis of the high volume denials and presents the findings to the Revenue Operations team. Communicates improvement opportunities and corrective action based on findings. When appropriate, bring issues to closure to prevent multiple hand-offs.
• Performs analytical review of denials to support Patient Financial Services, Case Management, Access, and other departments as it relates to denials. Determines reason for denials, meets with appropriate Revenue Operations leaders, and makes recommendations to prevent future denials.
• Identifies problems in process workflow and / or changes in payer's billing rules and regulations and governmental guidelines that slows cash flow and disseminates information to management.
• Collaborates with the Training department on developing education materials based from the resolution / outcome of the improvement opportunities presented at interdisciplinary meetings.
• Collaborates with Follow-Up Manager in developing process and workflow on trends identified on various areas of operation.
• Prepares trending reports of all high volume denials within the follow-up department's open accounts receivable. Meets biweekly and monthly with various departments to communicate findings and make recommendations to improve revenue management.
• SME (Subject Matter Expert) for complex denials and payment variances including contracts, fee schedules, and edits. Educates and provides feedback to various areas on Revenue Operations metrics and key performance indicators.
• Utilizes and develops new Epic and ad-hoc accounts receivable or denial reporting tools for management, using the current information system and / or other software programs to achieve desired reporting outcomes.
• Performs reimbursement management and tracks and reports on high volume discrepancies which will be used as escalation to Managed Care, the payer, or IT. Monitors denials and initiates CPT or DRG analysis to determine reason for denial.
• Monitors daily dashboard and reports and conducts analytical reviews to determine if changes or enhancements on current policies and procedures are required.
• Participates in meetings with appropriate personnel to exchange ideas on working towards accounts receivable related changes or enhancements and works closely with the Follow-Up Manager to develop required reports for meetings.
• Conducts accounts receivable audits as defined by SVP, Sr Revenue Officer and Patient Financial Services Managers.
• Meets bi-weekly and monthly with various vendors and outsource agencies to discuss bottlenecks in revenue flow and discusses solutions. Acts as liaison between agencies and Follow-Up department to prevent accounts receivable aging and ensures timely flow of communication.
• Monitors account work queues, analyzes trends, and follows up if metrics exceed or fall below baselines.
• Collaborates with Revenue Operations Analyst and Billing Analyst as needed.
• Able to perform all Third Party Follow-Up Representative functions / tasks.
• Other duties and / or projects as assigned.
• Adheres to HMH Organizational competencies and standards of behavior.

Qualifications

Education, Knowledge, Skills and Abilities Required :

Education, Knowledge, Skills and Abilities Preferred :

Licenses and Certifications Required :

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

Compensation

Minimum rate of $63,336.00 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 :

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