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Form of workWork where every moment matters.
Every day, approximately 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.
The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.
With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.
Position Summary:
HHC completes a systematic review of scheduled appointments for required elements that must be secured to achieve financial reimbursement. We also create an opportunity to strengthen the financial relationship with our consumers by providing pricing transparency and assisting them prior to service with understanding, navigating and fulfilling their consumer responsibilities.
This position encourages and represents HHC's mission in working towards responding to the needs of our communities and our patients.
The Denial Analyst role reviews accounts post payment via work queues; verify payer information, review payer filing order, determine root cause of existing authorization denials and initiate the appropriate action to pursue reimbursement. Document any and all applicable authorization information through a detailed review of an account to identify root cause of denial. Role must also focus on claim denial prevention by collaborating with clinical teams, business partners and insurance payers.
Hybrid-Telecommuting Position
Position Responsibilities:
1. Identifying, reviewing and interpreting third party payments, adjustments and denials
2. Validate accuracy of payer information including correct claims submission
3. Compile financial data required to verify accuracy of client's fee source/method of payment to confirm correct reimbursement
4. Complete thorough analysis of full account to identify if prior auth processes were completed correctly as well as denial root cause
5. Contact insurance companies to investigate denials related to pre-authorization/authorization
6. Document detailed pertinent information related to authorization activity while meeting established requirements in an effort to facilitate payer follow up and support denial dispute
7. Complete Retro Authorization and Appeals to secure reimbursement due
8. True to HHC Mission and Values, demonstrate positive and effective relationships across the continuum and support a coordinated care experience including timely and accurate communication with internal and external business partners
9. Collaborate and communicate with transitional care staff, clinical colleagues, medical offices and business partners
10. Adherence to the practice of confidentiality, HIPAA and other state/federal regulations. Ensure compliance with regulatory and agency policies and procedures
11. Demonstrate H3W Leadership behaviors and supports culture and team building initiatives.
Skills/Desired Attributes:
• Critical Thinking; Analytical skills
• Excellent oral and written communication skills; self-directed, with a spirit of team support and success
• Detail oriented
• Computer literacy including Microsoft Office and Excel
• Experience and interest in problem resolution and process improvement
• EPIC experience preferred
• Basic medical terminology
• Ability to perform in a production environment with a high-quality output of work
• Able to sit for 90% of the day
Qualifications:
Qualifications:
• Education: High School Diploma or GED is required, Associates Degree preferred
Experience: Minimum of two years billing, follow up and or denial follow up experience preferred
We take great care of careers .
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge - helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.
