Connecticut Children's
All Pointe HomeCare, A/R Follow Up Specialist - Full Time - Various Locations, C
Connecticut Children's, Hartford, Connecticut, us, 06112
Overview
All Pointe HomeCare – AR Follow Up Specialist (Full Time) – Hartford, CT and other locations in Connecticut. Position Summary: The AR Specialist-Homecare is responsible for managing all facets of the homecare accounts receivable to ensure timely and accurate billing, collections, and account resolution. The role covers billing operations, proactive follow-up on outstanding balances, denial management, accurate cash application, and coordination of appeals to optimize revenue recovery. The specialist collaborates with internal teams and external payers to resolve discrepancies, improve cash flow, and maintain compliance with company and regulatory requirements. Responsibilities
Billing Generate and submit accurate patient claims to insurance companies and government payers, ensuring compliance with healthcare regulations and coding standards. Claims are generated electronically for submission or entered into the payor portal as needed. Review the unbilled report daily to release claims in backlog that need to be billed; communicate with stakeholders to resolve issues that affect billing. Collaborate with Scheduling, Compliance, Coding, and Clinical staff to ensure proper documentation and accurate charge capture. Perform all client and school billing as needed for services provided. Perform direct patient billing and generate invoices for patient liabilities as needed. AR Follow-Up/Denial Management Follow up with payers to ensure timely resolution of all outstanding claims via phone, email, fax, or payor websites. Analyze accounts receivable aging reports to prioritize collection efforts and identify trends affecting cash flow. Investigate discrepancies between payments and billed amounts, including coding errors, missing documentation, or coverage limitations. Identify root causes of insurance denials and develop strategies for resolution; review denied or rejected claims to determine denial reasons and actions. Gather and organize necessary documentation (medical records, billing information, patient authorization forms) to support appeals. Prepare and submit formal appeal letters or requests following payer guidelines and deadlines. Follow up promptly on unresolved appeals to escalate issues and facilitate timely resolution. Remain current with payer policies, contracts, and administrative bulletins. Cash Application Apply payments and adjustments accurately to patient accounts, ensuring alignment with contractual agreements and patient records. Review and interpret Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERA) to ensure correct payment posting. Identify and research discrepancies in payment postings and coordinate with billing, collections, or insurance representatives to resolve issues. Contact payors directly for check discrepancies or ERA/EFT conversion requests. Complete daily balancing and reconciliation; ensure unapplied payments are resolved monthly per department goals. Other Operational Duties Maintain detailed documentation of billing, payment, and follow-up activities to support audits and compliance. Coordinate and manage home care audits; assist with month-end and year-end reporting related to accounts receivable and revenue cycle metrics. Ensure adherence to HIPAA regulations and patient confidentiality standards in all billing and collection activities. Identify opportunities for process improvements within the revenue cycle to increase efficiency and reduce days in accounts receivable. Communicate professionally with patients, insurance carriers, and internal departments to clarify billing issues and resolve discrepancies. Develop documentation and training workflows related to billing, AR/follow-up, and denials for the department. Participate in policy and procedure development to improve department workflow and the claims process, ensuring proper documentation. Attend applicable meetings, including payer meetings as appropriate; handle inbound patient accounting-related mail and other duties as needed. Organizational Structure
Reports to: Manager Billing & AR Follow Up. Supervisory Responsibility: No. Job titles reporting into role: n/a. Number of Direct Reports: n/a. Number of Indirect Reports: n/a. Qualifications
High School Diploma or GED. Associate’s Degree in Healthcare Management, Finance, or related field preferred. Minimum of 5 years of Billing, Accounts Receivable, and Denial Management experience in healthcare required. Specialization in home healthcare billing preferred. Experience must include billing of Medicare and Medicaid. Knowledge, Skills, And Abilities
Knowledge of billing and revenue cycle functions with specialization in AR follow-up, including claims submission, denials, adjudication, transaction reviews, adjustment posting, and patient responsibility. Knowledge of home care audits, regulations, and compliance requirements. Knowledge of medical terminology, diagnosis and procedure codes, and disability duration guidelines. Knowledge of coverage criteria guidelines for insurance coverage and the verification process. Knowledge of working payor denials and the appeal process. Knowledge of EOBs and ERA to reconcile payments accurately. Basic accounting skills for balancing and reconciling accounts. Proficiency with Microsoft Office (Word, Excel) and familiarity with QuickBooks; knowledge of Continulink is highly desired. Excellent verbal and written communication skills; detail-oriented with high accuracy; collaborative team player. Ability to analyze accounts receivable aging and financial data; strong problem-solving skills; able to work independently and in a team; effective time management and multitasking. About Us
Connecticut Children’s is the only health system in Connecticut dedicated to children, with over 100 years of legacy, 30 pediatric specialties, and a mission to transform children's health and well-being as one team. We value diversity, equity and inclusion and strive to create a welcoming environment for patients, families, and team members.
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All Pointe HomeCare – AR Follow Up Specialist (Full Time) – Hartford, CT and other locations in Connecticut. Position Summary: The AR Specialist-Homecare is responsible for managing all facets of the homecare accounts receivable to ensure timely and accurate billing, collections, and account resolution. The role covers billing operations, proactive follow-up on outstanding balances, denial management, accurate cash application, and coordination of appeals to optimize revenue recovery. The specialist collaborates with internal teams and external payers to resolve discrepancies, improve cash flow, and maintain compliance with company and regulatory requirements. Responsibilities
Billing Generate and submit accurate patient claims to insurance companies and government payers, ensuring compliance with healthcare regulations and coding standards. Claims are generated electronically for submission or entered into the payor portal as needed. Review the unbilled report daily to release claims in backlog that need to be billed; communicate with stakeholders to resolve issues that affect billing. Collaborate with Scheduling, Compliance, Coding, and Clinical staff to ensure proper documentation and accurate charge capture. Perform all client and school billing as needed for services provided. Perform direct patient billing and generate invoices for patient liabilities as needed. AR Follow-Up/Denial Management Follow up with payers to ensure timely resolution of all outstanding claims via phone, email, fax, or payor websites. Analyze accounts receivable aging reports to prioritize collection efforts and identify trends affecting cash flow. Investigate discrepancies between payments and billed amounts, including coding errors, missing documentation, or coverage limitations. Identify root causes of insurance denials and develop strategies for resolution; review denied or rejected claims to determine denial reasons and actions. Gather and organize necessary documentation (medical records, billing information, patient authorization forms) to support appeals. Prepare and submit formal appeal letters or requests following payer guidelines and deadlines. Follow up promptly on unresolved appeals to escalate issues and facilitate timely resolution. Remain current with payer policies, contracts, and administrative bulletins. Cash Application Apply payments and adjustments accurately to patient accounts, ensuring alignment with contractual agreements and patient records. Review and interpret Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERA) to ensure correct payment posting. Identify and research discrepancies in payment postings and coordinate with billing, collections, or insurance representatives to resolve issues. Contact payors directly for check discrepancies or ERA/EFT conversion requests. Complete daily balancing and reconciliation; ensure unapplied payments are resolved monthly per department goals. Other Operational Duties Maintain detailed documentation of billing, payment, and follow-up activities to support audits and compliance. Coordinate and manage home care audits; assist with month-end and year-end reporting related to accounts receivable and revenue cycle metrics. Ensure adherence to HIPAA regulations and patient confidentiality standards in all billing and collection activities. Identify opportunities for process improvements within the revenue cycle to increase efficiency and reduce days in accounts receivable. Communicate professionally with patients, insurance carriers, and internal departments to clarify billing issues and resolve discrepancies. Develop documentation and training workflows related to billing, AR/follow-up, and denials for the department. Participate in policy and procedure development to improve department workflow and the claims process, ensuring proper documentation. Attend applicable meetings, including payer meetings as appropriate; handle inbound patient accounting-related mail and other duties as needed. Organizational Structure
Reports to: Manager Billing & AR Follow Up. Supervisory Responsibility: No. Job titles reporting into role: n/a. Number of Direct Reports: n/a. Number of Indirect Reports: n/a. Qualifications
High School Diploma or GED. Associate’s Degree in Healthcare Management, Finance, or related field preferred. Minimum of 5 years of Billing, Accounts Receivable, and Denial Management experience in healthcare required. Specialization in home healthcare billing preferred. Experience must include billing of Medicare and Medicaid. Knowledge, Skills, And Abilities
Knowledge of billing and revenue cycle functions with specialization in AR follow-up, including claims submission, denials, adjudication, transaction reviews, adjustment posting, and patient responsibility. Knowledge of home care audits, regulations, and compliance requirements. Knowledge of medical terminology, diagnosis and procedure codes, and disability duration guidelines. Knowledge of coverage criteria guidelines for insurance coverage and the verification process. Knowledge of working payor denials and the appeal process. Knowledge of EOBs and ERA to reconcile payments accurately. Basic accounting skills for balancing and reconciling accounts. Proficiency with Microsoft Office (Word, Excel) and familiarity with QuickBooks; knowledge of Continulink is highly desired. Excellent verbal and written communication skills; detail-oriented with high accuracy; collaborative team player. Ability to analyze accounts receivable aging and financial data; strong problem-solving skills; able to work independently and in a team; effective time management and multitasking. About Us
Connecticut Children’s is the only health system in Connecticut dedicated to children, with over 100 years of legacy, 30 pediatric specialties, and a mission to transform children's health and well-being as one team. We value diversity, equity and inclusion and strive to create a welcoming environment for patients, families, and team members.
#J-18808-Ljbffr