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Connecticut Children's · 1 day ago

Revenue Cycle AR Specialist I - Full Time Hybrid

Hartford, CT

Full-time

Hybrid

Entry Level

1+ years exp

Connecticut Children’s is a health system dedicated to children, offering personalized medical care across various pediatric specialties. The Revenue Cycle AR Specialist I is responsible for resolving insurance balances, following up with payors, and submitting appeals on rejected claims to ensure accurate payment resolutions.

Health CareHospitalMedical

Responsibilities

Accurately and compliantly resolves insurance balances after payment or adjudication, and correctly identifies any patient liability (i.e., contractual/payment review, etc.) and ensures accurate resolution of account to payment or payor terms

Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites

Leverages available resources and systems (both internal and external) to analyze patient accounting information and take appropriate action for payment resolution; documents all activity in accordance with organization and payor policies

Coordinate appeal when claim is denied. May partner with medical care team members on complex appeals

Submits LOMN (Letter of Medical Necessity) and other drafted appeals and reconsiderations on rejected and denied claims

Sends appeals to payors, and follow up to ensure payment is made

Continue to review acct and escalate as necessary if denial is not overturned

Engages the CFC, UR, Revenue integrity or coding follow-up team for any medical necessity, auth. or coding related denials review

Sets follow-up activities based on status of the claim; ensure full and clear account documentation on account status within system

Collaborate as a part of a team on special projects by utilizing excel spreadsheets, and effectively communicate results Performs other job-related duties as assigned

Qualification

Healthcare Revenue CyclePatient BillingEpicExcel SpreadsheetsCommunication

Required

Applicants must reside in Connecticut, Massachusetts, or New York, or willing to relocate

High School Diploma, GED, or a higher level of education that would require the completion of high school

Minimum 1 year completed experience in a Healthcare Revenue Cycle role

Preferred

Associate's Degree in Healthcare Management, Finance, or related field

Experience with Epic

Patient billing experience preferred

Company

Connecticut Children's

Connecticut Children’s is a leading pediatric academic medical center consistently ranked by our peers as among the best children’s hospitals in the nation.

Founded in 1996

Hartford, Connecticut, USA

1001-5000 employees