Account Assistant 4

Yale University; New Haven, Northern (CT, KY); On-site; USD 26,000 - 44,000; Full time

Job summary

Yale University in New Haven, CT, seeks a Remote Insurance Follow-Up Specialist for Yale Medicine. You will handle denials, no-response claims, and claim edits to maximize reimbursement across Yale Medicine and related practices.

You will coordinate with Yale Medicine departments, patients, and third-party payers, ensuring adherence to guidelines while improving claim performance. This role requires CT residency and strong AR knowledge.

Qualifications

• Experience with healthcare revenue cycle operations, claims processing, denial management, and coding guidelines.
• Ability to analyze and resolve denials and payer issues, with attention to accuracy.
• Proficiency navigating billing systems, workqueues, and payer information.
• Strong analytical, problem-solving, and organizational skills.
• Excellent written and verbal communication for cross-department collaboration.

Responsibilities

• Serve as primary source of information on University accounts receivable rules and procedures.
• Oversee account file maintenance and review payment histories.
• Resolve delinquent accounts with supervisor and collection agency; assist with final dispositions.
• Recommend and implement system/process changes; draft AR letters and correspondence.
• Research individual accounts; summarize findings in reports and handle related clerical tasks.

Skills

Healthcare Revenue Cycle Knowledge

Denial and Claim Resolution

Billing System Proficiency

Analytical and Problem-Solving Skills

Communication and Organization

Education

High school diploma or equivalent

Associate's degree or equivalent experience

Tools

Waystar

Clearinghouse systems

Payer portals

Job description

Working at Yale means contributing to a better tomorrow. Whether you are a current resident of our New Haven-based community, eligible for opportunities through the New Haven Hiring Initiative, or a newcomer, interested in exploring all that Yale has to offer, your talents and contributions are welcome. Discover your opportunities at Yale!

Salary Range

$31.83

Overview

Under the direction and supervision of the Supervisor and Team Lead/Manager, employee will be responsible for insurance follow-up on carrier denials, no insurance response and claim edits for Yale Medicine. Employee will function as a liaison in the day to day follow-up of denied, no response claims and claim edits to obtain maximum reimbursement for services rendered by Yale Medicine and other related practices.

Follow up of denied and no insurance response for Yale Medicine and its related specialties and practices. Oversees maintenance of account files ensuring accuracy and completeness. Review payment history. Review, work and resolve problem and delinquent accounts with supervisor and collection agency. Recommend and implement changes to system and operation procedures. Compose form letters and correspondence used in account receivable activities. Researches individual accounts. Follow up of denials according to the rejection code posted in Epic and follow process guidelines established by the Central Business Office management team. Process and review carrier denials for adherence to specific payer Explanation of Benefits. Work collaboratively with YM staff to ensure maximum reimbursement. Directly communicate with third party insurance carriers, patients, and other listed payers in order to investigate payment/reimbursement delays for billed charges, for both primary and secondary claims. Respond to requests from insurance carriers, Yale Medicine clinical departments and/or patients for supporting documentation necessary in order to obtain maximum reimbursement. Work closely with other centralized and non centralized units within the Business Office to resolve outstanding claim/billing/payer issues or requests. Identify and report carrier/specialty issues that will assist in claim processing and resolution. Responsible for documentation and follow up of claims worked through payment, rejection or claim edits. Strong knowledge of insurance carrier and specialty related issues. Review and validate charge review and claim edits as assigned to ensure correct coding, billing guidelines and in compliance with Yale Medicine guidelines. Special projects as assigned by Yale Medicine staff and management and all other job related duties.

Remote within CT. Candidate must live in CT.

Required Skills and Abilities

• Healthcare Revenue Cycle Knowledge: Understanding of healthcare revenue cycle operations, insurance billing, claims processing, eligibility, reimbursement, and denial management. Knowledge and working experience with CPT, ICD10, HCPC, modifiers, National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edit’s (MUE’s).
• Denial and Claim Resolution: Ability to research, analyze, resolve, and/or appropriately escal
• Billing System and Workflow Proficiency: Ability to navigate billing systems, workqueues, patient accounts, claim details, payer information, and related revenue cycle workflows. Highly energetic and motivated with the ability to work under pressure and handle and maintain a high volume of accounts.
• Analytical and Problem-Solving Skills: Ability to analyze claim and denial information, identify the cause of issues, determine appropriate resolution, and apply knowledge of payer requirements and billing guidelines.
• Communication and Organization: Strong written and verbal communication skills with the ability to manage multiple priorities, meet productivity expectations, work independently, and collaborate effectively with internal departments, liaisons, and insurance payers.

Preferred Skills and Abilities

• Complex Denial and Appeal Experience: Experience managing complex or high-dollar denials, appeals, payer disputes, and identifying recurring denial trends and root causes.
• Revenue Cycle Technology Experience: Experience with Waystar or other clearinghouse and payer portal systems, claim edits, electronic claims, eligibility tools, and other revenue cycle applications.
• Process Improvement: Demonstrated ability to identify workflow issues, recommend process improvements, reduce recurring denials, and improve clean claim performance.
• Professional Certification or Coursework: CPC, CPB, or other relevant healthcare billing, coding, or revenue cycle certification or coursework.
• Reporting and Data Analysis: Experience using Microsoft Excel or other reporting and data analysis tools to monitor claim activity, identify trends, and support revenue cycle performance.

Principal Responsibilities

• Serves as a principal source of information on rules and procedures governing University accounts receivable. Oversees and instructs support staff.
• Oversees maintenance of account files, ensuring accuracy and completeness. Reviews payment histories.
• Resolves problem and delinquent accounts with supervisor and collection agency. Assists with final review and disposition of problem accounts.
• Recommends and implements changes to systems and operating procedures. Composes form letters and correspondence used in accounts receivable activities.
• Researches individual accounts. Summarizes findings in reports. Completes and processes forms. Performs clerical functions incidental to account activity.

Required Education and Experience

Four years of related work experience, two of them in the same job family at the next lower level, and high school level education; or two years of related work experience and an Associate's degree, or an equivalent combination of experience and education.

Time Type

Full time

Duration Type

Staff

Work Model

Remote

Location

221 Whitney Ave, New Haven, Connecticut

Background Check Requirements

All candidates for employment will be subject to pre-employment background screening for this position, which may include motor vehicle, DOT certification, drug testing and credit checks based on the position description and job requirements. All offers are contingent upon the successful completion of the background check. For additional information on the background check requirements and process visit "Learn about background checks" under the Applicant Support Resources section of Careers on the It's Your Yale website.

Health Requirements

Certain positions have associated health requirements based on specific job responsibilities. These may include vaccinations, tests, or examinations, as required by law, regulation, or university policy.

Posting Disclaimer

The intent of this job description is to provide a representative summary of the essential functions that will be required of the position and should not be construed as a declaration of specific dutiesand responsibilities of the position. Employees will be assigned specific job-related duties through their hiring department.

University policy is committed to affirmative action under law in employment of women, minority group members, individuals with disabilities, and protected veterans. Additionally, in accordance with Yale's Policy Against Discrimination and Harassment, and as delineated by federal and Connecticut law, Yale does not discriminate in admissions, educational programs, or employment against any individual on account of that individual's sex, sexual orientation, gender identity or expression, race, color, national or ethnic origin, religion, age, disability, status as a special disabled veteran, veteran of the Vietnam era or other covered veteran.

Inquiries concerning Yale's Policy Against Discrimination and Harassment may be referred to the Office of Institutional Equity and Accessibility (OIEA).

Note

Yale University is a tobacco-free campus.