Hartford HealthCare
Cust Svc Dispute Resol Analyst / PA Customer Service
Hartford HealthCare, Farmington, Connecticut, us, 06030
Cust Svc Dispute Resol Analyst / PA Customer Service
Location: 9 Farm Springs Rd, Farmington (10566)
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 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 organization.
With 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 Summary The Customer Service Dispute Resolution Analyst is responsible for analysis, investigation and resolution of all customer service requests, system-wide requiring a second level review. This individual will assess the patient’s complaint from a holistic perspective, considering charging, billing, documentation, reimbursement, and posting, and work with other departments both within and outside of Revenue Cycle. The analyst must possess critical thinking skills to determine appropriate escalation to the next level for unresolved or outstanding cases, keeping all parties involved and updated throughout the research phase and upon final resolution. Excellent communication skills are required for patient and colleague interaction, including de-escalation, empathy, compassion, and professionalism. The analyst will educate patients on billing intricacies and resulting balances. Experience across A/R, government and commercial insurance, federal and state regulations, self‑pay billing and collections, etc., is essential, as is initiative to research and resolve issues to completion on the patient’s behalf.
Key Areas of Responsibility
Respond to calls, emails, and faxes related to patient billing in a timely and professional manner, using a patient‑centric approach.
Understand healthcare billing and payer regulations to communicate effectively with patients about charges, payments and adjustments.
Investigate and analyze patient inquiries/disputes surrounding charging, coding, payments, locations, services, insurance coverage, etc., and work with appropriate individuals across the organization to resolve disputes.
Maintain a thorough, organized, updated electronic listing of dispute statuses, accessible to management at any time.
Establish and maintain effective communication with departments essential to patient resolution, including Patient Relations, Privacy and Compliance, Risk Management, HIM, Charge, A/R Follow Up, Denials, Coding, Remit, Site Managers, Practice Managers, and vendors.
Takes ownership of escalated patient complaints and their resolution, ensuring adherence to timely, compliant, and quality standards set by leadership.
Directs inquiries to appropriate departments if not related to insurance and patient balances.
Collaborate with the Customer Service Manager to identify trends, provide improved education, scripting, etc., to prevent similar situations and enhance patient experiences.
Identify barriers to efficient departmental operations and proactively develop solutions using the H3W model.
Must know Epic Navigation and all self‑pay workflows within the department; analyze associated accounts as needed.
Research and update self‑pay accounts (process credits, return mail, bankruptcy, addresses, insurances, etc.), process financial assistance applications, and assist with Independence at Home billing.
Working Relationships This Job Reports To: Manager, Customer Service
Qualifications Education
Minimum: Associate’s Degree
Preferred: Bachelor’s Degree
Experience
Minimum: 3‑5 years of experience in insurance and self‑pay billing, remit processing, patient access and/or collections.
Preferred: Minimum 1 year of experience in a multi‑entity system with EPIC; prior experience in patient relations or customer service for a healthcare entity.
Language Skills
Minimum: Fluent in English
Preferred: Fluent in English, Spanish and Polish
Knowledge, Skills & Ability Requirements
Outstanding customer service and interpersonal skills.
Superior communication, organizational, and analytical skills.
Understanding of hospital and professional revenue cycle.
Ability to work in a high‑volume setting and respond to patient inquiries promptly.
Ability to identify and communicate payer and/or system trends.
Knowledge of payer contracts, regulations, and guidelines, as well as state and federal laws related to billing, collection, and financial assistance.
Familiarity with medical and insurance terminology.
Proficiency in computer usage and relevant hospital software applications.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Finance and Sales (Hospitals and Health Care)
Salary: $62,600.00 – $99,000.00
Benefits Hartford HealthCare offers competitive benefits designed to support work/life balance. Join a cutting‑edge organization that brings new technologies, treatments, and community education to countless patients.
#J-18808-Ljbffr
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 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 organization.
With 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 Summary The Customer Service Dispute Resolution Analyst is responsible for analysis, investigation and resolution of all customer service requests, system-wide requiring a second level review. This individual will assess the patient’s complaint from a holistic perspective, considering charging, billing, documentation, reimbursement, and posting, and work with other departments both within and outside of Revenue Cycle. The analyst must possess critical thinking skills to determine appropriate escalation to the next level for unresolved or outstanding cases, keeping all parties involved and updated throughout the research phase and upon final resolution. Excellent communication skills are required for patient and colleague interaction, including de-escalation, empathy, compassion, and professionalism. The analyst will educate patients on billing intricacies and resulting balances. Experience across A/R, government and commercial insurance, federal and state regulations, self‑pay billing and collections, etc., is essential, as is initiative to research and resolve issues to completion on the patient’s behalf.
Key Areas of Responsibility
Respond to calls, emails, and faxes related to patient billing in a timely and professional manner, using a patient‑centric approach.
Understand healthcare billing and payer regulations to communicate effectively with patients about charges, payments and adjustments.
Investigate and analyze patient inquiries/disputes surrounding charging, coding, payments, locations, services, insurance coverage, etc., and work with appropriate individuals across the organization to resolve disputes.
Maintain a thorough, organized, updated electronic listing of dispute statuses, accessible to management at any time.
Establish and maintain effective communication with departments essential to patient resolution, including Patient Relations, Privacy and Compliance, Risk Management, HIM, Charge, A/R Follow Up, Denials, Coding, Remit, Site Managers, Practice Managers, and vendors.
Takes ownership of escalated patient complaints and their resolution, ensuring adherence to timely, compliant, and quality standards set by leadership.
Directs inquiries to appropriate departments if not related to insurance and patient balances.
Collaborate with the Customer Service Manager to identify trends, provide improved education, scripting, etc., to prevent similar situations and enhance patient experiences.
Identify barriers to efficient departmental operations and proactively develop solutions using the H3W model.
Must know Epic Navigation and all self‑pay workflows within the department; analyze associated accounts as needed.
Research and update self‑pay accounts (process credits, return mail, bankruptcy, addresses, insurances, etc.), process financial assistance applications, and assist with Independence at Home billing.
Working Relationships This Job Reports To: Manager, Customer Service
Qualifications Education
Minimum: Associate’s Degree
Preferred: Bachelor’s Degree
Experience
Minimum: 3‑5 years of experience in insurance and self‑pay billing, remit processing, patient access and/or collections.
Preferred: Minimum 1 year of experience in a multi‑entity system with EPIC; prior experience in patient relations or customer service for a healthcare entity.
Language Skills
Minimum: Fluent in English
Preferred: Fluent in English, Spanish and Polish
Knowledge, Skills & Ability Requirements
Outstanding customer service and interpersonal skills.
Superior communication, organizational, and analytical skills.
Understanding of hospital and professional revenue cycle.
Ability to work in a high‑volume setting and respond to patient inquiries promptly.
Ability to identify and communicate payer and/or system trends.
Knowledge of payer contracts, regulations, and guidelines, as well as state and federal laws related to billing, collection, and financial assistance.
Familiarity with medical and insurance terminology.
Proficiency in computer usage and relevant hospital software applications.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Finance and Sales (Hospitals and Health Care)
Salary: $62,600.00 – $99,000.00
Benefits Hartford HealthCare offers competitive benefits designed to support work/life balance. Join a cutting‑edge organization that brings new technologies, treatments, and community education to countless patients.
#J-18808-Ljbffr