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

Claims Investigator

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.

Job Responsibilities

• Claim review and analysis: Investigate denied or underpaid claims by reviewing EOBs, medical records, and account notes to determine the specific reason for the denial.
• Appeal preparation: Forward denied encounters to appropriate dept/vendor for written appeal with supporting documentation rationale.
• Print and mail appeals
• Payer communication: Follow up with insurance companies to check the status of appeals and provide additional information as needed.
• Trend identification: Identify root causes for denials and report recurring issues to management to help prevent future denials.
• Process improvement: Collaborate with other teams, such as billing and clinical staff, to implement process improvements that reduce avoidable denials.
• Record keeping: 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

Qualifications

Education:

Minimum: High school diploma

Other Desired Skills, Abilities, and Knowledge

• Analytical skills: Ability to analyze complex data, identify trends, and make informed decisions.
• Communication skills: Strong written and verbal communication skills for collaborating with internal and external stakeholders.
• Problem-solving: Critical thinking and problem-solving skills to navigate complex denial reasons.
• Organizational skills: Ability to manage a large caseload, prioritize tasks, and meet deadlines.
• Attention to detail: Meticulous attention to detail to ensure accuracy in documentation.
• Healthcare knowledge: Familiarity with payer guidelines, payer portals, and the claims process.
• Interpersonal skills: Ability to work independently and collaboratively with cross-functional teams.

About Us

At Atlantic Health, our promise to our communities is; anyone who enters one of our facilities will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development, and opportunities we give to our more than 22,000 team members. Headquarters in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:

• Atlantic Health Morristown Medical Center, Morristown, NJ
• Atlantic Health Overlook Medical Center, Summit, NJ
• Atlantic Health Newton Medical Center, Newton, NJ
• Atlantic Health Chilton Medical Center, Pompton Plains, NJ
• Atlantic Health Hackettstown Medical Center, Hackettstown, NJ
• Atlantic Health Goryeb Children's Hospital, Morristown, NJ
• Atlantic Health CentraState Healthcare System, Freehold, NJ
• Atlantic Medical Group
• Atlantic Visiting Nurse
• Atlantic Mobile Health
• Atlantic Rehabilitation

We have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group.

We have received awards and recognition for the services we have provided to our patients, team members, and communities. Below are just a few of our accolades:

• Chosen for 17 years by Fortune as one of the magazine's "100 Best Companies to Work For."
• Atlantic Health Morristown and Atlantic Health Overlook Named by Newsweek as two of the "World's Best Hospitals" in 2026.
• Atlantic Health Morristown and Atlantic Health Overlook ranked within the top three hospitals in New Jersey by U.S. News & World Report's 2025-2026 Best Hospital rankings.
• Atlantic Health scored four "A" grades by The Leapfrog Group in its Fall 2025 Hospital Safety Grades, performance measures reflecting errors, accidents, injuries and injections, as well as systems hospitals have in place to prevent harm.
• Atlantic Health Morristown and Atlantic Health Overlook are New Jersey's only hospitals to be named among America's 50 Best hospitals by Healthgrades in 2026.
• Named by Becker's Healthcare as one of the "165 Top Places to Work in Healthcare 2026.
• Atlantic Health Morristown, Atlantic Health Overlook, Atlantic Health Chilton and Atlantic Health Newton all Forbes Top Hospitals for 2026.
• Named by Newsweek as one of America's Greatest Workplaces for Inclusion & Diversity 2025.
• Atlantic Health rated LEVEL 9 - 2025 CHIME Digital Health Most Wired.

Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted:

Team Member 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

Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.

EEO STATEMENT

Atlantic Health, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran.