A/R Follow Up Specialist Full Time

Job Description All employees must be a resident of CT, MA, or NY to work for CT Children's The Denials and Payment Variance claims analyst is responsible for performing complex analyses and receipt of payment related to A/R not paid according to contract or denied by a carrier and or governmental agency. This position supports the needs of the revenue cycle departments, including Patient Access, Health Information Management, and Patient Accounting. Reports to the Manager, of Payment Variance and Denials. Responsibilities Prepares /reviews statistical data reports to track and trend underpayments. Maintains automated work que of accounts Demonstrates proficiency in the ability to apply contracting analysis to claims resolution. Prepares analysis for payer meetings. Identifies carrier issues are suggests measures for resolution. Participates in staff meetings. Other duties in support of CBO operations, as assigned by manager. Adheres to all HIPPA and compliance standards. Ability to multi-task, prioritize needs and meet required timelines. Attention to detail and accuracy. Proactively identifies areas of opportunity for improvement and effectively communicates to manager Remains current with core knowledge of specific payer policies, contracts and administrative bulletins. Demonstrates support for the mission, values and goals of the organization through behaviors that are consistent with the CT Children's standards. Qualifications Education Required: High School Diploma, GED, or a higher level of education that would require the completion of high school, is required. Experience Required: Prior experience in healthcare or managed care environment that included post billing review. Experience Preferred: Previous SMS or EPIC systems experience preferred. KNOWLEDGE, SKILLS AND ABILITIES REQUIRED Ability To: Effectively bring complex issues to a satisfactory resolution with both internal and external partners Multi-task, prioritize needs and meet required deadlines. Skills: Excellent communication skills and ability to work independently. Knowledge Of: CD-9 and CPT-4 coding. Intermediate level user of Windows operating system, and Microsoft Office applications (Word, Excel). About Us Connecticut Children's is the only health system in Connecticut that is 100% dedicated to children. Established on a legacy that spans more than 100 years, Connecticut Children's offers personalized medical care in more than 30 pediatric specialties across Connecticut and in two other states. Our transformational growth establishes us as a destination for specialized medicine and enables us to reach more children in locations that are closer to home. Our breakthrough research, superior education and training, innovative community partnerships, and commitment to diversity, equity and inclusion provide a welcoming and inspiring environment for our patients, families and team members. At Connecticut Children's, treating children isn't just our job - it's our passion. As a leading children's health system experiencing steady growth, we're excited to expand our team with exceptional team members who share our vision of transforming children's health and well-being as one team.

Created: 2024-11-05