Insurance Biller/Systems Accounts Resolution Analyst Full Time 40 hours

BRISTOL HOSPITAL GROUP•Bristol, CT

30d•Onsite

About The Position

In a hospital and/or professional office environment, the Systems Account Resolution Analyst is responsible for billing and patient account reconciliation. This job requires critical thinking skills, organizational skills, account investigation, claim escalation, and overall account resolution of a patients and/or insurance balances. This is accomplished by utilizing insurance web portals, call inquiries, written correspondence, and collaborating with internal departments. This role requires an employee to work in a team environment as well as independently. The System Account Resolution Analyst will contribute to meeting departmental goals as well and organizational goals.

Requirements

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
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
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
Adapts at PC use - computer keyboard with minimum error.
Must maintain daily flexibility including but not limited to sitting and standing.
Requires continual use of computer screen access and data input requiring dexterity and movement.
Ability to efficiently move about the Business Office to retrieve and seek information necessary to decision make is required.
Vision and hearing corrected to normal is essential.
Must be able to think independently, analyze information, execute written and oral instructions, follow directions, speak, write and understand English and have good mathematical aptitude.

Nice To Haves

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

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