Accts Receivable Team Lead / PA Non Medicare Billing

Accounts Receivable Follow Up/Denials Specialist

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 Connecticuts 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

Responsible for assisting the Accounts Receivable (AR) Follow Up/Denials Supervisor, in the day-to-day operations of the AR Follow Up & Denials Specialist Level 1, Level 2 and Level 3. Daily Operations consist of monitoring timely and accurate collection of third-party payers, resolving outstanding insurance claims across all Hartford HealthCare hospitals, medical group and homecare. Assuring the organization is complying with all federal/state guidelines, keeps abreast of all regulations and standards to ensure compliance with governmental/regulatory agencies or third-party payers, responsible for Epic quality assurance to ensure high quality and cost-effective products or services are delivered. Responsible for daily work queue inflow, account activity assignment, weekly aging and dashboard monitoring. Provides leadership to the team regarding management of technical functions, vendors and client relations through project management, relationship building and internal department collaboration, organizational awareness and input to Yearly Performance Appraisals/SMART Goals. Supports the HHC core values, strategic plan and established Patient Financial Services goals and objectives.

Position Responsibilities

Key Areas of Responsibility:

• Assisting supervisor and team with timely realization of payment for approximately $550+ million in active inventory and $70 million in denials, assisting with the effective resolution of denials, underpayments and credit balances. These numbers will increase with new acquisitions.
• Supporting the supervisor with:
• Implementing and monitoring meaningful goals and objectives
• Tracking trends and results
• Improving quality and productivity
• Identifying opportunities
• Recommending and assisting to implement changes
• Documenting and implementing policies and procedures
• Oversight and management of individual performance expectations
• Coaching and developing
• Employee and professional development
• Training opportunities
• Vendor relationships and performance
• Providing input on decisions that affect workflows effecting timely resolution of insurance claims.
• Providing support for other ad hoc analyses and projects as needed.
• May contribute to the outcomes of the defined function by performing the work of the function as required (minimal).
• Effectively and continually communicates with staff, management and customers to facilitate the flow of information. Demonstrates H3W Leadership Behaviors.
• Actively seeks opportunities to model teamwork through collaboration both within and outside the workgroup in support of the organizations objectives.
• Assumes responsibility for self-improvement in collaboration with superior.
• Maintain effective positive customer service, ensuring the needs are met and educating staff on the importance of quality customer service.
• Provides training support for colleagues.
• Daily Huddle Leader.
• Performs other duties as assigned.

Working Relationships

This Job Reports To: AR Follow Up/Denials Supervisor

Job Title(s) of HHC positions reporting to this Job: Assist AR Follow Up Supervisor and AR Collections Specialists in their efforts to review and resolve issues related to insurance claim denials, no response claims and payment variances including underpayments and overpayments. Provides ongoing support and training to AR Collections Specialists as needed. Participates in the process of interviewing applicants and provides feedback to hiring manager. Assists in the onboarding and training of new AR Collections Specialists.

Number- Direct Reports: 0

Number- Indirect Reports: 10+

If applicable, describe nature of supervision of any External vendors, contractors, affiliate organizations, etc.: Assist supervisor with the tracking and monitoring of accounts receivables engagements with small balance, out of state Medicaid and credit vendors as needed.

Qualifications

Requirements and Specifications:

Education

• Minimum: High school diploma, GED or equivalent
• Preferred: Associates degree in health care administration, business management or finance or equivalent healthcare revenue cycle experience.

Experience

• Minimum: 4+ years medical billing and/or accounts receivable in a facility or professional healthcare revenue cycle setting.
• Preferred: 4+ years medical billing and/or accounts receivable experience in a facility or professional healthcare revenue cycle setting. 1-3 years supervisory experience in a facility or professional medical billing and/or accounts receivables setting.

Licensure, Certification, Registration

• Preferred: American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) certification

Knowledge, Skills and Ability Requirements

• Epic experience and working knowledge of Resolute Hospital and Professional billing modules preferred
• Excellent analytical and problem solving skills
• Excellent communication skills both written and verbal and interpersonal skills
• Knowledge of state and federal regulations as they pertain to billing processes and procedures
• Knowledge of insurance claim processing and third party reimbursement
• Knowledge and detailed understanding of all negotiated agreements
• Demonstrated leadership in establishing and achieving goals
• Ability to communicate effectively both orally and in writing, strong computer and math skills required
• Skill in problem solving in a variety of settings
• Skill in time management and project management