Third Party Follow-Up Analyst

THIRD PARTY FOLLOW‑UP ANALYST role at JFK Johnson Rehabilitation Institute

Third Party Follow‑Up Analyst HMH HOSPITALS CORPORATION Borough of Tinton Falls, New Jersey

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 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.

• 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, brings 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 slow cash flow and disseminates information to management.
• Collaborates with the Training department on developing education materials based on the resolution/outcome of the improvement opportunities presented at interdisciplinary meetings.
• Collaborates with Follow‑Up Manager in developing process and workflow on trends identified in 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 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 toward 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…