Account Representative - Oncology - Physician Practice

Hackensack Meridian Health; Brick Township (NJ); On-site; USD 65,000 - 160,000; Full time

Job summary

Join a leading healthcare provider as an Account Representative in Oncology at Hackensack Meridian Health. You will play a critical role in billing and revenue cycle management at a busy multi-location practice, ensuring efficient operations and excellent patient advocacy. Ideal candidates will have experience in medical billing and familiarity with oncology terms.

Benefits

Competitive benefits package

Paid leave and tuition reimbursement

Qualifications

• 2 years experience in a hospital or clinical office setting required.
• Prior authorization experience preferred.
• Preference for oncology terminology knowledge.

Responsibilities

• Handles billing questions and advocates for patients.
• Manages authorizations and eligibility verification.
• Submits prior authorizations for oncology services.

Skills

Knowledge of ICD-10 and CPT codes

Medical terminology understanding

Billing knowledge

EHR experience (EPIC or ARIA)

Education

High School diploma or GED

Job description

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Description

Our team members are the heart of what makes us better.

Description

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 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.
  
  

Responsibilties

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.
  
  

Qualifications

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!

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.

Job Duties

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. Starting at $20.32 Hourly

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Sales and Business Development

• Industries

  Hospitals and Health Care

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