Manager, Third-Party Follow-up - Edison, New Jersey, United States
1 day ago
Job description
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 Manager of Third Party Follow-Up at the Hackensack Meridian Health (HMH) network directly manages, through proper planning and delegation, the HMO, Blue Cross, Commercial, Government and Managed Care for third-party follow-up. Responsibilities include managing the day to day activities of multiple Supervisors and Analysts in addition to approximately 20-30 team members to ensure accounts are collected and resolved timely in accordance with established departmental goals and objectives.
Responsibilities
A day in the life of a Manager of 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 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 insurance disputes for HMO, Blue Cross, Government, and Managed Care payers as assigned.
- 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 and Slicer/Dicer 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 Operations 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 managers and CDM coordinator on coding and charging processes.
- Collaborates with Ambulatory Registration in reducing denials.
- Manages quarterly Medicare credit balance report.
- Participates in monthly meetings 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.
Qualifications
Education, Knowledge, Skills and Abilities Required:
- Bachelor's degree; or equivalent relevant HMH experience at approximately 6-8 years.
- Minimum of 5+ 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 with proficiency in various software including but not limited to Microsoft Suite (Word and Excel) and/or Google Applications.
- Excellent written and verbal communication skills.
- Excellent interpersonal and analytical skills.
Education, Knowledge, Skills and Abilities Preferred:
- MBA in finance or MPA in Healthcare Administration.
- Knowledge of EPIC.
- Knowledge of Google suite of applications and Microsoft applications.
Licenses and Certifications Preferred:
- Healthcare Financial Management Association Certification or Certified Healthcare Financial Professional.
If you feel that the above description speaks directly to your strengths and capabilities, then please apply today
Starting Minimum Rate
Minimum rate of $131,144.00 Annually
Job Posting Disclosure
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.
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