Accts Rec & Denial Spec 1 / PA Third Party Follow Up

Hartford HealthCare Corp.•Farmington, CT

9d•Onsite

About The Position

Under the direction of a Patient Financial Service (PFS), Accounts Receivable (AR), or Claims Supervisor, the Accounts Receivable & Denial Specialist 1 supports timely, accurate claim submission and insurance-balance follow-up across Hartford HealthCare hospitals, medical group, and homecare. The role monitors clearinghouse responses and electronic file transmission (EFT) responses; follows up with payers about underpayments, overpayments, denials, rejections, claim edits, and credit balances; and performs revenue-cycle activities related to outstanding insurance balances. Daily work includes managing queue inflow, monitoring dashboards and aging, tracking work in progress, assigning account activity, and collaborating with internal departments while meeting productivity and quality standards. The specialist keeps current with regulations and standards to support compliance with governmental, regulatory, and commercial-payer requirements and federal and state guidelines. The position contributes to timely cash collections across a large active inventory and denial balance, supports appropriate payment to Hartford HealthCare, and works toward Patient Financial Services goals and organizational objectives. The role reports to the AR Follow Up/Denials Supervisor. Hartford HealthCare describes its System Support Office as a system-wide organization with common practices, payroll, benefits, performance management, and service-recognition programs. The position is located at 9 Farm Springs Road, Farmington, Connecticut.

Requirements

High school diploma, GED, or equivalent.
At least 1–2 years of medical billing or accounts-receivable experience in a medical facility or professional healthcare revenue-cycle setting, and/or banking experience.
Excellent analytical and problem-solving skills.
Time-management skills and ability to work efficiently under pressure.
Ability to operate a computer and applications such as Word, Excel, and PowerPoint.
Ability to work independently, take initiative, and accept responsibility.
Commitment to continuous learning and ability to apply learning in operations.
Ability to adapt to constant change and act as a change agent.
Ability to deal effectively with difficult people and situations.
Ability to set priorities, use sound judgment, and exercise independent judgment in unusual or stressful situations.
Ability to establish and maintain effective working relationships.

Nice To Haves

Associate’s degree in healthcare administration, business management, or finance.
Three or more years of medical billing and/or accounts-receivable 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.
EPIC experience and working knowledge of hospital and professional billing modules.

Responsibilities

Support timely cash collections of insurance payments for approximately $550+ million in active inventory and $70 million in denials.
Follow up directly with commercial and governmental payers to resolve denials, underpayments, nonpayments, payer rejections, claim edits, and credit balances.
Reconcile outstanding balances and exhaust appropriate payer follow-up efforts—including calls, payer websites, and payer chat—before write-off.
Respond to insurance-company inquiries and follow up on issues to help ensure payment.
Meet productivity and quality performance expectations set by leadership.
Document claim status and actions taken in clear, concise notes in the EPIC system.
Work with leadership to identify, trend, and address accounts-receivable root causes, and keep leadership informed of issues or trends.
Manage day-to-day work-queue inflow, monitor dashboards and weekly aging, track work in progress, and assign account activity.
Collaborate with internal departments and communicate with peers, management, and colleagues to facilitate information flow.
Demonstrate H3W Leadership Behaviors and model teamwork within and outside the workgroup.
Take responsibility for self-improvement in collaboration with a supervisor.
Provide effective, positive customer service and ensure customer needs are met.
Perform other duties as assigned.