Billing Associate 2 Full Time

Company: Connecticut Children''s Medical Center
Location: Hartford
Posted on: May 21, 2023

Job Description:

Job DescriptionThe Billing Associate II is responsible for follow-up on accounts as assigned by the Assistant Manager, to ensure all claims have been appropriately billed within 30 days and brought to resolution within 60 days. Responsible for the analysis and follow-up of denied claims, file appeals when appropriate, process carrier inquiries (both written and oral) and initiate refunds when necessary. Works under general supervision following established protocols and procedures. Maintains confidentiality of all information. Reports to Sr. Manager.ROLE RESPONSIBILITIESReviews and maintains billing processes to establish timely cash collections with the payerAnalyzes accounts daily to ensure all claims are worked within 30 days and target goal, as set by Sr. Manager, is metAudits delinquent and aging insurance claim reports, researches and reconciles outstanding accounts to resolve issues and determine if adjustment, correction, or rebilling should take place. Follows through with third party payers to resolve payment issues and ensure timely receipt of paymentsDetermines appropriate judgment on claims over 60 days oldRetrieves all medical documentation and initiates appeal process when appropriateDetermines when payer refund is necessary and initiates paperworkSeeks ways and opportunities to increase productivity and efficiency, while maintaining or improving qualityActs as a liaison between practices and the billing office to ensure timely resolution to inquiriesIdentifies and directs, based on payer policy guidelines, all requests for write-offs to management for approvalInitiates contact with provider reps when appropriate to resolve difficult claim issues Performs related duties as required in support of dept operationsDemonstrates knowledge of the population-specific differences and needs of patients in appropriate, specific populations from neonate through adolescence and applies them to practice. Demonstrates cultural sensitivity in all interactions with patients/families and co-workers.Demonstrates support for the mission, values and goals of the organization through behaviors that are consistent with the CCMC STANDARDSEducation and ExperienceHigh School Diploma, GED, or a higher level of education that would require the completion of high school, is required3 years professional billing experienceLicenses and CertificationsCertification in medical coding preferred

Keywords: Connecticut Children''s Medical Center, Hartford , Billing Associate 2 Full Time, Accounting, Auditing , Hartford, Connecticut