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Bristol Hospital and Health Care Group, Inc. · 3 months ago

Insurance Biller/Systems Accounts Resolution Analyst Full Time 40 hours

Bristol, CT

Full-time

Onsite

Mid Level

3+ years exp

Bristol Hospital and Health Care Group, Inc. has been an integral part of the community for the past 100 years, dedicated to providing quality care and service. The Systems Account Resolution Analyst is responsible for billing and patient account reconciliation, utilizing critical thinking and organizational skills to resolve patient and insurance balances while collaborating with various departments.

Health CareHospitalMedicalNon ProfitPrimary and Urgent Care

Responsibilities

Contacts insurance carriers to facilitate payments, review underpayments and denials. Refer difficult accounts to denials team for further action

Identifies barriers to efficient departmental operations related to self-pay billing/trends in insurance denial and takes an active role in developing appropriate solutions

Actively works daily work queue and clearing house denials

Assists the self-pay follow up team in areas such processing financial assistance applications, payment plans through third party vendor, preparing patient refund requests, processing bankruptcy notifications, return mail, etc

Reviews payer bulletins to stay current on updates

Communicates with departments and Coding Vendor to resolve claim issues

Respond and takes action related to calls, emails, and faxes related to patient billing in a timely and professional manner

Uses a patient-centric approach to answer questions and provide information in a professional manner

Understand all payer regulations to effectively communicate with patients about charges, payments and adjustments on their account

Investigate patient inquiries/disputes surrounding charging, coding, payments, locations, services, insurance coverage, etc

Works with individuals when appropriate at various levels of the organization to find resolution on patient disputes

Updates account information (addresses, insurance, etc.) and rebills as appropriate to initiate the next steps in the billing and collection cycle

Qualification

Revenue cycle experienceInsurance billingPatient account reconciliationOffice Applications proficiencyMedical terminology knowledgePayer regulations knowledgeCustomer service skillsAnalytical skillsOrganizational skillsInterpersonal skillsTeamworkCritical thinking

Required

High School Diploma and at least three (3) years of revenue cycle experience which may include insurance and self-pay billing and collections, remittance processing, patient access and/or are other revenue cycle areas in a hospital or physician office setting

Communicate effectively and work directly with third parties (insurance payers, patients, internal departments, vendors, leadership, etc.) to relay updates on patient accounts timely

Ability to read and write in English is required

Organize and articulate account disputes, and written letters of appeal

Excellent customer service and communication as well as interpersonal, organizational and analytical skills

Proficient in Office Applications (e.g. Excel, Word, Google Sheets, Google Mail)

Comprehensive knowledge of Professional and/or Hospital revenue cycle

Ability to work in a high volume setting and respond to insurance or patient inquiries in a timely manner

Ability to identify and communicate payer trends and/or system trends

Ability to navigate payer websites

Proficient in the use of a computer and relevant hospital software applications e.g., Meditech and/or eClinicalWorks

Understanding and adherence to HIPAA Regulations and Release of Information Rules

Models teamwork through cooperation and collaboration within and outside the work group

Ability to attain productivity and quality standards per department requirements

Preferred

Bachelor's Degree Preferred

Knowledge of payer contracts, regulations and guidelines, as well as State and Federal laws relating to billing, collection, and financial assistance procedures preferred

Familiar with medical and insurance terminology