USA Jobs
Accounts Receivable & Denial Specialist II
USA Jobs, Unionville, Connecticut, United States, 06085
Accounts Receivable & Denial Specialist II
Work where every moment matters. Every day, more than 40,000 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 Connecticut's most comprehensive healthcare network. The story of Hartford HealthCare is the story of transformation - from a handful of disconnected organizations a decade ago to a unified system with a shared, value-based culture of accountability and innovation. The healthcare landscape has become highly competitive, with new players and disruptive technology and we are working to expand and create our system's organizational, leadership, cultural, and talent capabilities to ensure Hartford HealthCare will always be the first. The Accounts Receivable & Denial Specialist II assures timely and accurate submission of claims on UB04 or HCFA1500 (bills), monitor responses from clearinghouse, review Electronic File 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. Accounts Receivable & Denial Specialist II is responsible for the following when a claim is denied; takes appropriate action for payment resolution; documents all activity in accordance with standard work; maximizes insurance reimbursement timely with commercial and governmental payers; responds to inquiries or follow up on issues and provide information to resolve outstanding balances. Resolves denials, underpayments, no pays, payer rejections, claim edits and credit balances with commercial and governmental payers; discovers root cause for denials, underpayments or delay and propose opportunity; discovers/identifies denials based on contract and/or fee schedule; performs due diligence in reconciling outstanding balances ensuring all efforts have been exhausted in resolving issues with payers, prior to write-off; works with leadership; to identify, trend and address root causes of issues in the AR. Intermittently exceeds productivity and quality performance expectations. Education: High school diploma, GED or equivalent Experience: 2 years medical billing or accounts receivables in a medical facility or professional healthcare revenue cycle setting and/or banking experience Knowledge, Skills and Ability Requirements Epic experience and working knowledge of Resolute Hospital and Professional billing modules preferred; understanding of medical and insurance terminology, facility and professional billing/reimbursement practices. Familiar with CPT, revenue codes and ICD10 codes 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 - 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 work/life balance. Every moment matters. And this is your moment.
Work where every moment matters. Every day, more than 40,000 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 Connecticut's most comprehensive healthcare network. The story of Hartford HealthCare is the story of transformation - from a handful of disconnected organizations a decade ago to a unified system with a shared, value-based culture of accountability and innovation. The healthcare landscape has become highly competitive, with new players and disruptive technology and we are working to expand and create our system's organizational, leadership, cultural, and talent capabilities to ensure Hartford HealthCare will always be the first. The Accounts Receivable & Denial Specialist II assures timely and accurate submission of claims on UB04 or HCFA1500 (bills), monitor responses from clearinghouse, review Electronic File 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. Accounts Receivable & Denial Specialist II is responsible for the following when a claim is denied; takes appropriate action for payment resolution; documents all activity in accordance with standard work; maximizes insurance reimbursement timely with commercial and governmental payers; responds to inquiries or follow up on issues and provide information to resolve outstanding balances. Resolves denials, underpayments, no pays, payer rejections, claim edits and credit balances with commercial and governmental payers; discovers root cause for denials, underpayments or delay and propose opportunity; discovers/identifies denials based on contract and/or fee schedule; performs due diligence in reconciling outstanding balances ensuring all efforts have been exhausted in resolving issues with payers, prior to write-off; works with leadership; to identify, trend and address root causes of issues in the AR. Intermittently exceeds productivity and quality performance expectations. Education: High school diploma, GED or equivalent Experience: 2 years medical billing or accounts receivables in a medical facility or professional healthcare revenue cycle setting and/or banking experience Knowledge, Skills and Ability Requirements Epic experience and working knowledge of Resolute Hospital and Professional billing modules preferred; understanding of medical and insurance terminology, facility and professional billing/reimbursement practices. Familiar with CPT, revenue codes and ICD10 codes 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 - 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 work/life balance. Every moment matters. And this is your moment.