Quality Rev Cyc Billing Spec​/PA Third Party Follow Up

Overview

Quality Rev Cyc Billing Spec / PA Third Party Follow Up – Hartford Health Care

Location:

9 Farm Springs Rd, Farmington, CT 10566

Work where every moment matters. Hartford Health Care is CT’s most comprehensive healthcare network. This role is part of the System Support Office, with a focus on a unified payroll, benefits, performance management, and common practices across the system.

The Quality Revenue Cycle Billing and Auditor Specialist is responsible for ensuring accuracy, compliance, and efficiency within the billing office. The auditor will implement and maintain an audit and education program for the billing office, for internal revenue cycle colleagues and external vendors involved in Hospital Billing and Professional Billing Revenue Cycle. The Auditor will contribute to the development of the billing office staff.

Expected outcomes include reducing denial errors, improving billing practices, ensuring proper write-offs, and aligning with regulatory and organizational standards.

• Completes quality and productivity audits of team members and vendors to ensure high-quality work; provides feedback and retraining as appropriate.
• Works with management on employee issues to evaluate quality and productivity; compiles and prepares reports for key stakeholders.
• Analyzes errors and workflows to identify opportunities for improvement and standardization.
• Communicates changes or updates via memos and documentation to disseminate compliant requirements.
• Prepares material and trains staff and vendors to improve colleagues  skills for handling denials and navigating the billing system (Epic); assesses training needs and develops curriculum and programs, evaluating training effectiveness.
• Assists in creating new patient finance workflows, department policies and protocols; ensures successful implementation and acts as a role model by applying Hartford Health Care s H3W business model.
• Provides support for ad hoc analyses and projects; contributes to decisions affecting workflows for timely resolution of insurance accounts.
• Maintains current knowledge of payer policies, system policies, and procedures; tracks changes in healthcare laws, insurance policies, and billing codes (CPT, ICD
  10, HCPCS); assists in audits related to billing and claims.
• Researches payer policies from in- and out-of-network payers to provide feedback to colleagues.
• Communicates effectively with staff, management, and customers to facilitate information flow; demonstrates H3W Leadership Behaviors.

Reports To:

Director of Accounts Receivable

• Minimum:
  Associate’s degree in health care administration, business management, or finance, or equivalent healthcare revenue cycle experience.
• Preferred:
  Bachelor’s degree in health care administration, business management, or finance, or equivalent healthcare revenue cycle experience.

• Minimum: 3–4 years medical billing or accounts receivable in a medical facility or professional healthcare revenue cycle setting and/or banking experience.
• Preferred: 5+ years of medical billing and/or accounts receivable experience in a large facility or professional healthcare revenue cycle setting.

• Preferred: AAPC or AHIMA certification.

• Epic experience and working knowledge of Resolute Hospital and Professional billing modules required.
• Understanding of medical and insurance terminology, and billing/reimbursement practices for facility and professional settings.
• Familiar with CPT, revenue codes, and ICD-10 codes.
• Analytical and problem-solving skills; excellent written and verbal communication and interpersonal skills.
• Knowledge of state and federal billing regulations; insurance claim processing and third-party reimbursement; negotiated agreements.
• Demonstrated leadership, ability to communicate effectively, strong math and computer skills; ability to work independently and manage time; willingness to adapt to change and train others.
• Ability to train large groups and engage in Process Improvement initiatives.

Hartford Health Care offers opportunities for career development and growth across locations. We provide a competitive benefits program designed to support work/life balance. Every moment matters. And this is your moment.