Systems Accounts Resolution Analyst Full Time 40 hours

Bristol Hospital Group•Bristol, CT

About The Position

The Systems Accounts Resolution Analyst works in a hospital and/or professional office environment and is responsible for billing and patient account reconciliation. The role uses critical thinking, organization, account investigation, claim escalation, and account-resolution skills to address patient and insurance balances through insurance web portals, calls, written correspondence, and collaboration with internal departments. The analyst works both independently and as part of a team and contributes to departmental and organizational goals. The position supports patient-centered billing and account resolution, including communication with patients, insurance carriers, vendors, and internal departments. It requires familiarity with revenue-cycle processes, payer requirements, and relevant hospital software, as well as the ability to manage high volumes of inquiries and work toward departmental productivity and quality standards.

Requirements

High school diploma.
At least three years of revenue-cycle experience, which may include insurance or self-pay billing and collections, remittance processing, patient access, or other revenue-cycle work in a hospital or physician-office setting.
Ability to communicate effectively and work directly with insurance payers, patients, internal departments, vendors, and leadership to provide timely account updates.
Ability to read and write in English.
Ability to organize and articulate account disputes and prepare written appeal letters.
Strong customer-service, communication, interpersonal, organizational, and analytical skills.
Proficiency with office applications such as Excel, Word, Google Sheets, and Google Mail.
Comprehensive knowledge of professional and/or hospital revenue-cycle processes.
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 and system trends.
Ability to navigate payer websites.
Proficiency using a computer and relevant hospital software applications, such as Meditech and/or eClinicalWorks.
Understanding of and adherence to HIPAA regulations and Release of Information rules.
Ability to collaborate within and outside the work group.
Ability to meet department productivity and quality standards.
Ability to use a computer keyboard with minimal errors.
Ability to think independently, analyze information, execute written and oral instructions, follow directions, speak, write, and understand English, and demonstrate good mathematical aptitude.
Ability to maintain daily flexibility, including sitting and standing; continual computer-screen access and data input requiring dexterity and movement; and movement through the Business Office to retrieve information.
Vision and hearing corrected to normal.

Nice To Haves

Bachelor's degree.
Knowledge of payer contracts, regulations, and guidelines, as well as state and federal laws relating to billing, collections, and financial-assistance procedures.
Familiarity with medical and insurance terminology.

Responsibilities

Contact insurance carriers to facilitate payments and review underpayments and denials.
Refer difficult accounts to the denials team for further action.
Identify barriers to departmental operations related to self-pay billing and insurance denial trends, and help develop appropriate solutions.
Work daily work queues and clearinghouse denials.
Assist the self-pay follow-up team with financial assistance applications, third-party payment plans, patient refund requests, bankruptcy notifications, and returned mail.
Review payer bulletins to stay current on updates.
Communicate with departments and the coding vendor to resolve claim issues.
Respond and take timely action on patient-billing calls, emails, and faxes.
Answer patient questions and provide information professionally using a patient-centric approach.
Apply payer regulations when communicating with patients about account charges, payments, and adjustments.
Investigate patient inquiries and disputes involving charges, coding, payments, locations, services, or insurance coverage.
Work with individuals at appropriate organizational levels to resolve patient disputes.
Update account information, including addresses and insurance, and rebill accounts as appropriate.