Third Party Follow-up Representative

Responsibilities

• 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.

Qualifications

• 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.
• Demonstrated computer literacy.

Skills and Abilities

• Some post-secondary education.
• Knowledge of EPIC.
• Experience with Google applications.

Benefits

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.