Farmington, Connecticut, USA
6 days ago
Accts Rec & Denial Spec 1 / PA Third Party Follow Up
Work where every moment mattersEvery day more than Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the system Position SummaryUnder the direction of Patient Financial Service PFS Accounts Receivable AR or Claims Supervisor assure timely and accurate submission of claims on UB or HCFA bills monitor responses from clearinghouse review EFT Electronic File Transmission responses respond on underpayments or overpayments via payer portal payer chat or payer customer service analyze claim adjustment reason codes analyze remittance advice remark codes and any revenue cycle activities associated with outstanding insurance balances across all Hartford HealthCare hospitals medical group and homecare These duties include the managing of the day to day work queue inflow dashboard monitoring weekly agingrsquos Work in Progress WIP account activity assignment and internal department collaboration with daily productivity and quality standards that are tracked and monitored Keeps abreast of all regulations and standards to ensure compliance with governmentalregulatory agencies or commercial payers Assists the organization to comply with all federalstate guidelines Responsible to meet quality standards cost effective products or services are delivered in support of the HHC core values strategic plan and established Patient Financial Services goals and objectives which is not limited to HHC receiving the appropriate payment Position ResponsibilitiesKey Areas of ResponsibilityFunctions as a member of the team that is responsible for the timely cash collections of insurance payments for approximately million in active inventory and million in denialsWhen a claim is deniedA Follows up directly with commercial and governmental payors to resolve denials underpayments no pays payor rejections claim edits and credit balancesB Reconciles outstanding balances ensuring all efforts have been exhausted calling insurance companies using the payer web pages utilizing payer chat function in resolving issues with payers prior to write offC Responds to insurance companies inquires for follow up on issues to ensure paymentD Meets productivity and quality performance expectations as provided by leadershipE Documents clear and concise notes in the EPIC system regarding claim status and any actions taken on an accountF Works with leadership to identify trend and address root causes of issues in the AR Keeps leadership informed of any issues or trendsCommunicates with peers management and internal colleagues to facilitate the flow of information Demonstrates HW Leadership BehaviorsActively seeks opportunities to model teamwork through collaboration both within and outside the workgroup in support of the organizationrsquos objectivesAssumes responsibility for self improvement in collaboration with superiorMaintains effective positive customer service ensuring the needs are metPerforms other duties as assigned Working RelationshipsThis Job Reports To Job Title AR Follow UpDenials SupervisorWork where every moment mattersEvery day more than Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the system Position SummaryUnder the direction of Patient Financial Service PFS Accounts Receivable AR or Claims Supervisor assure timely and accurate submission of claims on UB or HCFA bills monitor responses from clearinghouse review EFT Electronic File Transmission responses respond on underpayments or overpayments via payer portal payer chat or payer customer service analyze claim adjustment reason codes analyze remittance advice remark codes and any revenue cycle activities associated with outstanding insurance balances across all Hartford HealthCare hospitals medical group and homecare These duties include the managing of the day to day work queue inflow dashboard monitoring weekly agingrsquos Work in Progress WIP account activity assignment and internal department collaboration with daily productivity and quality standards that are tracked and monitored Keeps abreast of all regulations and standards to ensure compliance with governmentalregulatory agencies or commercial payers Assists the organization to comply with all federalstate guidelines Responsible to meet quality standards cost effective products or services are delivered in support of the HHC core values strategic plan and established Patient Financial Services goals and objectives which is not limited to HHC receiving the appropriate payment Position ResponsibilitiesKey Areas of ResponsibilityFunctions as a member of the team that is responsible for the timely cash collections of insurance payments for approximately million in active inventory and million in denialsWhen a claim is deniedA Follows up directly with commercial and governmental payors to resolve denials underpayments no pays payor rejections claim edits and credit balancesB Reconciles outstanding balances ensuring all efforts have been exhausted calling insurance companies using the payer web pages utilizing payer chat function in resolving issues with payers prior to write offC Responds to insurance companies inquires for follow up on issues to ensure paymentD Meets productivity and quality performance expectations as provided by leadershipE Documents clear and concise notes in the EPIC system regarding claim status and any actions taken on an accountF Works with leadership to identify trend and address root causes of issues in the AR Keeps leadership informed of any issues or trendsCommunicates with peers management and internal colleagues to facilitate the flow of information Demonstrates HW Leadership BehaviorsActively seeks opportunities to model teamwork through collaboration both within and outside the workgroup in support of the organizationrsquos objectivesAssumes responsibility for self improvement in collaboration with superiorMaintains effective positive customer service ensuring the needs are metPerforms other duties as assigned Working RelationshipsThis Job Reports To Job Title AR Follow UpDenials SupervisorRequirements and SpecificationsEducationmiddot Minimum High school diploma GED or equivalentmiddot Preferred Associatersquos degree in health care administration business management or financeExperiencemiddot Minimum years medical billing or accounts receivables in a medical facility or professional healthcare revenue cycle setting andor banking experiencemiddot Preferred years of medical billing andor accounts receivables experience in a large facility or professional healthcare revenue cycle settingLicensure Certification Registrationmiddot Preferred American Academy of Professional Coders AAPC or American Health Information Management Association AHIMA certificationKnowledge Skills and Ability Requirementsmiddot Epic experience and working knowledge of Hospital and Professional billing modules preferredmiddot Excellent analytical and problem solving skillsmiddot Skill in problem solvingmiddot Skill in time managementmiddot Ability to work efficiently under pressuremiddot Ability to operate a computer and related applications such as Word Excel PowerPoint etcmiddot Ability to work independently and take initiativemiddot Ability to demonstrate a commitment to continuous learning and to operationalize that learningmiddot Ability to deal effectively with constant changes and be a change agentmiddot Ability to deal effectively with difficult people andor difficult situationsmiddot Ability to willingly accept responsibilitymiddot Ability to set priorities and use good judgment for selfmiddot Ability to exercise independent judgment in unusual or stressful situationsmiddot Ability to establish and maintain effective working relationships We take great care of careers With locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour moment Requirements and SpecificationsEducationmiddot Minimum High school diploma GED or equivalentmiddot Preferred Associatersquos degree in health care administration business management or financeExperiencemiddot Minimum years medical billing or accounts receivables in a medical facility or professional healthcare revenue cycle setting andor banking experiencemiddot Preferred years of medical billing andor accounts receivables experience in a large facility or professional healthcare revenue cycle settingLicensure Certification Registrationmiddot Preferred American Academy of Professional Coders AAPC or American Health Information Management Association AHIMA certificationKnowledge Skills and Ability Requirementsmiddot Epic experience and working knowledge of Hospital and Professional billing modules preferredmiddot Excellent analytical and problem solving skillsmiddot Skill in problem solvingmiddot Skill in time managementmiddot Ability to work efficiently under pressuremiddot Ability to operate a computer and related applications such as Word Excel PowerPoint etcmiddot Ability to work independently and take initiativemiddot Ability to demonstrate a commitment to continuous learning and to operationalize that learningmiddot Ability to deal effectively with constant changes and be a change agentmiddot Ability to deal effectively with difficult people andor difficult situationsmiddot Ability to willingly accept responsibilitymiddot Ability to set priorities and use good judgment for selfmiddot Ability to exercise independent judgment in unusual or stressful situationsmiddot Ability to establish and maintain effective working relationships We take great care of careers With locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour moment
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