Third Party Follow-up Representative

2 weeks ago

Tinton Falls, United States Hackensack Meridian Health Full time

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** Third Party Follow-up Representative** performs follow-up procedures on unpaid third party accounts by accessing Payer Portals and calling insurance payers, where applicable.

**Responsibilities**:
A day in the life of a** Third Party Follow-up Representative** at Hackensack Meridian _Health_ includes:

- Performs account analysis to ascertain the required follow-up procedure.
- Researches suspended/pending claims and transfers information to the payer.
- Prepares report for payer for large volume of outstanding claims.
- Reports collection efforts/issues for high dollar accounts to management at monthly meetings.
- Processes third party vouchers and verifies accuracy and timeliness of payment.
- Reconciles managed care payments to the explanation of benefits to determine patients' responsibility and performs comparison to managed care contract for accuracy.
- Initiates aging reports by financial class in order to identify problematic areas and accelerate cash flow.
- Resubmits claims to payers via hard copy, fax, or electronic medium.
- 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.
- Other duties and/or projects as assigned.
- Adheres to HMH Organizational competencies and standards of behavior.

Qualifications:
**Education, Knowledge, Skills and Abilities Required**:

- High School diploma, general equivalency diploma (GED), and/or GED equivalent programs.
- Minimum of 1+ years of experience in revenue cycle or equivalent experience.
- Strong written and verbal communication skills.
- Detail-oriented and organized.
- Demonstrated computer literacy.

**Education, Knowledge, Skills and Abilities Preferred**:

- Some post-secondary education.
- Knowledge of EPIC.

**Licenses and Certifications Required**:

- Successfully pass completion of EPIC assessment within 30 days after Network access granted.

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