Systems Accounts Resolution Analyst/Insurance Biller Full Time- Full Time 40 Hours

At Bristol Health we begin each day caring today for your tomorrow. We have been an integral part of our community for the past 100 years. We are dedicated to providing the best possible care and service to our patients residents and families. We are committed to provide compassionate quality care at all times and to uphold our values of Communication Accountability Respect and Empathy (C.A.R.E.). We are Magnet and received the 2020 Press Ganey Leading Innovator award for our rapid adoption and implementation of healthcare solutions during the COVID-19 pandemic. Use your expertise compassion and kindness to transform the patient experience. Make a difference. Make Bristol Health your choice.

Job Summary

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.

Essential Job Functions and 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

Qualifications

• 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. Bachelors Degree Preferred
• 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

State/Federal Mandated Licensure or Certification Requirements:

• None.

Bristol Hospital Mandated Educational Requirements:

• General orientation at time of hire. Fire/Safety/Infection Control annually. Other programs as mandated by Hospital.

Special Requirements:

• Adapts at PC use - computer keyboard with minimum error.

• Physical Requirements:
• 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.

Work Environment:

• Normal office conditions.

• Cognitive Requirements:
• 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.
• Disclaimer
• The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities duties and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time as needed.