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Claims Adjudication Representative FT Days

new bridge health Paramus, NJ
  • Posted: over a month ago
  • Full-Time
  • Benefits: Vision, Medical, Life Insurance, 401k, Dental

JOB SUMMARY

Responsible to post payments and 835 remittance files to the Paragon accounts receivables and review associated remittances. Utilize Paragon, Claims Administrator, Horizon Patient Folder, Pathways Contract Management, and Emdeon applications.


Process all 835 remittance files in the Paragon system, and all other related duties.

Post all hard copy payments to the Paragon system.

Process telephone payment requests.

Accept window payments.

Handle petty cash transactions for Patient Transportation requests.

Prepare daily bank deposit for all monies received and posted to the system.

Index all scanned payments in the Horizon Patient Folder application.

Review all remittance statements in comparison to the estimated amount due on the specific patient account. Flag accounts with variances which must be forwarded to the AR Management representative, utilize ticklers to do so.

Monitor auto secondary crossovers information on remittance to Paragon payor information, if not matching, alert AR and EDI team for system updates and required billing.

Post contractual allowances where required.

Satisfy payor in Paragon wherever payment matches expected reimbursement amount.

Monitor PCON reports for payment variances.

Understands and adheres to departmental policies and procedures

Adheres to the Medical Center’s Code of Conduct.

Customer Service: respect, flexibility, knowledge, confidence, professionalism, pleasant attitude, patience and helpfulness. All responses should be timely, professional, caring, and respectful in accordance with Customer Service Performance expectations

Maintains established departmental policies and procedures, objectives, quality assurance program, safety, environmental, and infection control standards. Assesses gaps in policies and procedures, and create necessary policies and procedures to fulfill these gaps.

Understands and adheres to the Medical Center’s Code of Conduct.

Familiar with the Medical Center’s Mission, Vision, and Values Statements.


OTHER JOB DUTIES

Attends required meetings

Assists in training of new and established employees

Performs other related duties as required.


BASIC COMPETENCIES

Education:

High school graduation or equivalent required.

Experinece:

Minimum of 6 months experience in medical billing procedures, with familiarity with third party insurer regulations required.

Minimum of 6 months of experience as bank teller, cashier in a hospital cashiers office, clerical experience in an insurance company, or clerical experience relating to insurance verification in physician’s office required, or suitable combination of education and experience

Skills:

Typing: 25 WPM.

Intermediate level computer skills required, to include Excel and Word.

Computerized billing knowledge essential.

Good oral and written communication skills.

Good interpersonal skills.

Speaks, reads and writes English to the extent required by the position.

Ability to plan and utilize time management skills.

Good organizational skills.

new bridge health

Why Work Here?

Bergen New Bridge Medical Center is the largest hospital in New Jersey with 1,075 beds. We believe in giving nothing but the best in care.

Bergen New Bridge Medical Center, a clinical affiliate of Rutgers Biomedical and Health Sciences, is a 1,070 bed hospital located at 230 East Ridgewood Avenue in Paramus, NJ. Founded in 1916 to treat patients with contagious diseases, the medical center has grown to become both the largest hospital and licensed nursing home in New Jersey and the fourth-largest publicly-owned hospital in the nation. A safety net facility, Bergen New Bridge Medical Center, renamed in October 2017, provides high-quality comprehensive services including long term care, behavioral health care, substance abuse treatment, and acute care to the greater Bergen County community. The medical center, including its Long Term Care Division, is fully accredited by The Joint Commission. With 323 behavioral health beds and 84 medical detox beds, New Bridge Medical Center is one of the largest medical facilities providing a continuum of care for those in need of behavioral health and/or substance abuse treatment. Please apply on our website: https://www.newbridgehealth.org/careers/

Address

230 East Ridgewood Avenue, Paramus, NJ 07652
Paramus, NJ
USA

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