Hartford HealthCare · 3 months ago
Quality Rev Cyc Billing Spec / PA Third Party Follow Up
Farmington, CT
Full-time
Onsite
Mid Level
3+ years expHartford HealthCare is Connecticut’s most comprehensive healthcare network, dedicated to ensuring every moment matters. The Quality Revenue Cycle Billing and Auditor Specialist is responsible for maintaining accuracy and compliance within the billing office, implementing audit and education programs, and contributing to the development of billing office staff to reduce denial errors and improve billing practices.
Health CareHealth DiagnosticsHospitalOncologyPharmaceuticalRehabilitation
Responsibilities
Completes quality and productivity audits of team members and vendors to ensure high quality work is being performed provides feedback and re-training as appropriate
Works closely with the management team when employee issues arise to assist in evaluating quality and productivity
Compiles and prepares reports for distribution to key stakeholders
Analyzes errors and workflows to find opportunities for improvement and standardization
Identifies common issues and effectively communicates changes or updates via memos and other documentation to disseminate compliant requirements
Collaboratively and independently prepares material and trains staff and vendors to prepare and improve colleague's skills for working denials and navigating the billing system (Epic) while assessing training needs and develops curriculum and training programs and evaluates the effectiveness of the training, importance of quality follow-up and documentation
Collaboratively and independently in the creation of new patient finance workflows, department policies and protocols and engages the colleagues to ensure successful implementation of the information
Acts as a role model for team members by incorporating the H3W business model of Hartford Healthcare to improve workflows, eliminate waste and provide a patient-centric experience into daily work
Provides support for other ad hoc analyses and projects as needed
Provides input on decisions that affect workflows affecting timely resolution of insurance accounts
Maintains current knowledge of established payer policies, system policies and procedures which may include, but not limited to patient confidentiality/patient rights, collections, government, and third-party payer regulations
Keep up to date with changes in healthcare laws, insurance policies, and billing codes (CPT, ICD10 & HCPCS) and assist in preparing for internal or external audits related to billing and claims
Research payer policies from in and out of network payers to provide feedback to colleagues; not limited to leadership
Effectively and continually communicates with staff, management and customers to facilitate the flow of information
Qualification
Required
Minimum: Associate's degree in health care administration, business management or finance or equivalent healthcare revenue cycle experience
Minimum: 3 to 4 years medical billing or accounts receivables in a medical facility or professional healthcare revenue cycle setting and/or banking experience
Epic experience and working knowledge of Resolute Hospital and Professional billing modules, required
Understanding of medical and insurance terminology, facility and professional billing/reimbursement practices
Familiar with CPT, revenue codes and ICD10 codes
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 understanding of 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
Ability to work efficiently under pressure
Ability to operate a computer and related applications such as Word, Excel, PowerPoint, etc
Ability to work independently and take initiative
Ability to demonstrate a commitment to continuous learning and to operationalize that learning
Ability to deal effectively with constant changes and be a change agent
Ability to deal effectively with difficult people and/or difficult situations
Ability to willingly accept responsibility and/or delegate responsibility
Ability to set priorities and use good judgment for self and peers
Ability to exercise independent judgment in unusual or stressful situations
Ability to establish and maintain effective working relationships
Ability to support new ideas and exercises flexibility if changes are initiated
Ability to understand workflows and train to a large group
Ability to engage in Process Improvement initiatives
Preferred
Bachelor's degree in health care administration, business management or finance or equivalent healthcare revenue cycle experience
5+ years of medical billing and/or accounts receivables experience in a large facility or professional healthcare revenue cycle setting
American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) certification
Benefits
Competitive benefits program designed to ensure work/life balance
Company
Hartford HealthCare
Hartford HealthCare is a group of hospitals that offers complete healthcare services including cancer care, rehabilitation and pharmacy.
10001+ employees
H1B Sponsorship
Hartford HealthCare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (9)
2024 (2)
2023 (4)
2022 (6)
2021 (4)
2020 (8)
Funding
Current Stage
Late StageTotal Funding
$150MKey Investors
Connecticut Health and Educational Facilities Authority
2024-04-01Debt Financing· $150M
Leadership Team
Jeffrey Flaks
President & Chief Executive Officer, Hartford HealthCare
Bimal Patel
Executive Vice President/ Chief Operating Officer
Recent News
Hartford Business Journal
2025-12-18
Company data provided by crunchbase