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 Electronic Fund Transmission EFT 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 Support and perform high level AR Denial Specialist tasks to improve operations and problem solve by developing solutions after analyzing data Maintains a high level understanding of the operational aspects of the entire revenue cycle as well as the appropriate measures to take in resolving claim issues with payersThis position is responsible for researching insurance company issues such as network problems work comp claims and a variety of special projects 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 ensure high quality 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 high level 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 Takes appropriate action for payment resolution documents all activity in accordance with standard workB Initiates updates resolves denials and payment variances and takes action to resolve account including drafting and submitting appeals identifying specific reason for underpayments denials and cause of payment delays Maximizes insurance reimbursement timely with commercial and governmental payersC Resolves denials based on contract andor fee scheduleD Performs due diligence in reconciling outstanding balances ensuring all efforts have been exhausted in resolving issues with payers prior to write offE Leverages available resources and systems both internal and external to analyze patient accounting information and take appropriate action for payment resolution documents all activity in accordance with standard workF Prepares research and documentation in preparation for meetings with provider reps that will assist in resolution of payer specific issuesG Works with leadership to identify trend and address root causes of issues in the ARH Improves quality and productivity by identifying opportunities and assisting with workflow changesI Assists in development of standard work to improve accuracy and understanding of processesJ Consistently exceeds productivity and quality performance expectationsEffectively and continually communicates with peers management and customers 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 superiorMaintain effective positive customer service ensuring the needs are met and educating staff on the importance of quality customer serviceProvides support for other ad hoc analyses and projects as neededProvide team support during team vacations and unexpected absenceTraining support for onboarding of new colleaguesFunctions as Daily Huddle LeaderPerforms other duties as assigned Working RelationshipsThis Job Reports To AR Follow UpDenials SupervisorIf applicable describe nature of supervision of any External vendors contractors affiliate organizations etcAssist supervisor with the tracking and monitoring of accounts receivables engagements with small balance out of state Medicaid and credit vendors as neededWork 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 Electronic Fund Transmission EFT 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 Support and perform high level AR Denial Specialist tasks to improve operations and problem solve by developing solutions after analyzing data Maintains a high level understanding of the operational aspects of the entire revenue cycle as well as the appropriate measures to take in resolving claim issues with payersThis position is responsible for researching insurance company issues such as network problems work comp claims and a variety of special projects 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 ensure high quality 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 high level 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 Takes appropriate action for payment resolution documents all activity in accordance with standard workB Initiates updates resolves denials and payment variances and takes action to resolve account including drafting and submitting appeals identifying specific reason for underpayments denials and cause of payment delays Maximizes insurance reimbursement timely with commercial and governmental payersC Resolves denials based on contract andor fee scheduleD Performs due diligence in reconciling outstanding balances ensuring all efforts have been exhausted in resolving issues with payers prior to write offE Leverages available resources and systems both internal and external to analyze patient accounting information and take appropriate action for payment resolution documents all activity in accordance with standard workF Prepares research and documentation in preparation for meetings with provider reps that will assist in resolution of payer specific issuesG Works with leadership to identify trend and address root causes of issues in the ARH Improves quality and productivity by identifying opportunities and assisting with workflow changesI Assists in development of standard work to improve accuracy and understanding of processesJ Consistently exceeds productivity and quality performance expectationsEffectively and continually communicates with peers management and customers 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 superiorMaintain effective positive customer service ensuring the needs are met and educating staff on the importance of quality customer serviceProvides support for other ad hoc analyses and projects as neededProvide team support during team vacations and unexpected absenceTraining support for onboarding of new colleaguesFunctions as Daily Huddle LeaderPerforms other duties as assigned Working RelationshipsThis Job Reports To AR Follow UpDenials SupervisorIf applicable describe nature of supervision of any External vendors contractors affiliate organizations etcAssist supervisor with the tracking and monitoring of accounts receivables engagements with small balance out of state Medicaid and credit vendors as neededRequirements 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 American Academy of Professional Coders AAPC or American Health Information Management Association AHIMA certificationKnowledge Skills and Ability Requirementsmiddot Epic experience and working knowledge of Resolute Hospital and Professional billing modules preferredmiddot Understanding of medical and insurance terminology facility and professional billingreimbursement practicesmiddot Familiar with CPT revenue codes and ICD codesmiddot Excellent analytical and problem solving skillsmiddot Excellent communication skills both written and verbal and interpersonal skillsmiddot Knowledge of state and federal regulations as they pertain to billing processes and proceduresmiddot Knowledge of insurance claim processing and third party reimbursementmiddot Knowledge and understanding of negotiated agreementsmiddot Demonstrated leadership in establishing and achieving goalsmiddot Ability to communicate effectively both orally and in writing strong computer and math skills requiredmiddot Skill in problem solving in a variety of settingsmiddot 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 responsibility andor delegate responsibilitymiddot Ability to set priorities and use good judgment for self and peersmiddot 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 American Academy of Professional Coders AAPC or American Health Information Management Association AHIMA certificationKnowledge Skills and Ability Requirementsmiddot Epic experience and working knowledge of Resolute Hospital and Professional billing modules preferredmiddot Understanding of medical and insurance terminology facility and professional billingreimbursement practicesmiddot Familiar with CPT revenue codes and ICD codesmiddot Excellent analytical and problem solving skillsmiddot Excellent communication skills both written and verbal and interpersonal skillsmiddot Knowledge of state and federal regulations as they pertain to billing processes and proceduresmiddot Knowledge of insurance claim processing and third party reimbursementmiddot Knowledge and understanding of negotiated agreementsmiddot Demonstrated leadership in establishing and achieving goalsmiddot Ability to communicate effectively both orally and in writing strong computer and math skills requiredmiddot Skill in problem solving in a variety of settingsmiddot 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 responsibility andor delegate responsibilitymiddot Ability to set priorities and use good judgment for self and peersmiddot 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