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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 Account Representative is responsible for billing and Revenue Cycle follow up. Ensures the accuracy and completeness of all submissions for maximum reimbursement. Responsible for timely and accurate posting of all payments and adjustments. Follows appropriate procedures/workflows depending on EHR.

This is a very busy oncology practice with two locations: Brick and Red Bank.

We are looking for someone that can work at either or both location - based on their preference

Brick:  We have 5 staff members and 1 Medical Doctor and  1 Nurse Practicioner
Red Bank: We have 5 staff members and 4 Medical Doctors and 2 Nurse Practicioners

• We are looking fo someone with a minimum of 2 years of experience in a hospital setting or medical/clinical office.
• Prior experience with an electronic health record system (especially EPIC clinical or ARIA) preferred.
• Prior relevant experience, such as doing prior authorizations in a medical doctor office, or related hospital or Physician based services.
• Demonstrated knowledge of medical terminology, preferably in Oncology, with strong understanding of cancer medical terminology.
  
• Experience in analyzing the NCCN, FDA and CMS guidelines for cancer diagnosis.
  

Some of the main responsiblites:

• Obtains Referrals/Authorizations and Verifies eligibility, submits requests for prior authorizations for all oncology services as prescribed by the Clinical care team and conformance to Hackensack Meridian Oncology/Radiation standards and protocols within the network.
• Submits all referral information to necessary providers, as appropriate.
• Assists with pre-authorizations of hospital admissions, procedures, medications and medical equipment.
  

A day in the life of an Account Representative at Hackensack Meridian Health includes:

• Liaison to our patients as it relates to their billing questions both in person and by phone.
• Advocates for patients when their claims are not paid properly.
• Manages all insurance plans who need auths/referrals, etc.
• Provides billing education to staff and providers.
• Responsible for all letters of medical necessity, record requests from insurance companies.
• Review denials and communications from MCX as needed.
• Runs and reviews revenue cycle reports as necessary.
• Communicates effectively and professionally with co-workers, insurance companies, management and physician office staff.
• Communicates trends or problems with payers.
• Accurately record all transactions posted each day. At the end of each month the logs are forwarded to appropriate staff in finance.
• Entering Charges: All supplied charge information is entered into the computer system timely and accurately.
• Insurance Knowledge: Knowledge of billing rules as they apply to specific payers. Able to detect and report trends, account lead and management.
• Responsible for all account receivable.
• Prepares Bank Deposit as directed by practice manager.
• Assists office manager with clinical insurance requirements.
• Posts all Medical Record request fees.
• Attends all revenue cycle meetings, front end meetings, Epic update meetings and all billing and coding inservices.
• Disseminated all pertinent takeaways to staff and providers as needed.
• Responsible for working Epic Work Que's daily.
• Runs all EPIC Revenue Cycle reports daily, weekly and monthly.
• Answer Phones promptly, callbacks are done within 24 hours of receiving messages. All written or verbal communication with patients, insurance companies and office staff is documented in medical record.
• Cross trained and used to backfill a Medical Receptionist whenever needed.
• Other duties and/or projects as assigned.
• Adheres to HMH Organizational competencies and standards of behavior.

Education, Knowledge, Skills and Abilities Required:

• High School diploma, general equivalency diploma (GED), and/or GED equivalent programs.
• Prior billing knowledge.
• Possess the knowledge of ICD-10 and CPT codes to ensure accurate processing claims and denials.

Licenses and Certifications Preferred:

• Certified Professional Coder.

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