Patient Financial Service Representative, Full Time, Days, 7a-3p, PFS - Revenue Cycle Integrity, Morristown, NJ

Atlantic Health System•Morristown, NJ

4d•$24 - $40•Onsite

About The Position

Responsible for supporting management in investigating denied or underpaid inpatient and outpatient claims by reviewing EOBs, medical records, and account notes to determine specific reason for denial. Collaborate with other departments and appeal vendors to ensure appropriate reimbursement, identify denial trends, and documentation of accurate findings. Follow up with insurance companies to check status of appeals and provide additional information as needed. Print and mail appeals.

Requirements

Reviewing EOBs, medical records, and account notes to determine the specific reason for the denial.
Forwarding denied encounters to appropriate dept/vendor for written appeal with supporting documentation rationale.
Following up with insurance companies to check the status of appeals and provide additional information as needed.
Identifying root causes for denials and reporting recurring issues to management.
Collaborating with other teams, such as billing and clinical staff, to implement process improvements that reduce avoidable denials.
Maintaining detailed and accurate records of all denial and appeal activities in the system, including all communications and actions taken.
Recording outcome and adjusting balances in Epic.
Reconciling invoices from vendor.

Responsibilities

Investigate denied or underpaid claims by reviewing EOBs, medical records, and account notes to determine the specific reason for the denial.
Forward denied encounters to appropriate dept/vendor for written appeal with supporting documentation rationale.
Print and mail appeals.
Follow up with insurance companies to check the status of appeals and provide additional information as needed.
Identify root causes for denials and report recurring issues to management to help prevent future denials.
Collaborate with other teams, such as billing and clinical staff, to implement process improvements that reduce avoidable denials.
Maintain detailed and accurate records of all denial and appeal activities in the system, including all communications and actions taken.
Record outcome and adjust balances in Epic.
Reconcile invoices from vendor.

Benefits

Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)
Life & AD&D Insurance.
Short-Term and Long-Term Disability (with options to supplement)
403(b) Retirement Plan: Employer match, additional non-elective contribution
PTO & Paid Sick Leave
Tuition Assistance, Advancement & Academic Advising
Parental, Adoption, Surrogacy Leave
Backup and On-Site Childcare
Well-Being Rewards
Employee Assistance Program (EAP)
Fertility Benefits, Healthy Pregnancy Program
Flexible Spending & Commuter Accounts
Pet, Home & Auto, Identity Theft and Legal Insurance