Systems Accounts Resolution Analyst Full Time 40 hours

Bristol Hospital Incorporated; Bristol (CT); On-site; USD 48,000 - 72,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Paid time off (PTO) and paid leave

403(b) retirement savings with company

Company matching

Life insurance

Employee assistance program

Wellness programs

Job summary

Bristol Health is seeking a Systems Account Resolution Analyst to support billing and patient account reconciliation in a hospital setting. You will collaborate with insurance payers, internal departments, and third-party vendors to resolve denials, underpayments, and balance inquiries.

The role emphasizes critical thinking, organizational skills, and the ability to work both independently and in a team. Experience in revenue cycle and HIPAA guidelines is expected.

Qualifications

• 3+ years in revenue cycle including insurance and self-pay billing
• Ability to read and write in English is required
• Strong analytical, organizational and communication skills

Responsibilities

• Contacts insurance carriers to facilitate payments and review underpayments and denials
• Assists self-pay follow up including payment plans and bankruptcy notifications
• Reviews payer bulletins to stay current on updates
• Communicates with departments and Coding Vendor to resolve claim issues
• Investigates patient inquiries/disputes surrounding charging, coding, payments and insurance coverage

Skills

Revenue cycle

Billing & collections

Customer service

Payer communications

English proficiency

Education

High School Diploma

Bachelor's Degree Preferred

Tools

Meditech

eClinicalWorks

Excel

Google Sheets

Job description

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.We offer a comprehensive benefits package designed to support the health, financial well-being, and work-life balance of our employees and their families. Eligible team members have access to medical, dental, and vision insurance, paid time off (PTO) and paid leave, a 403(b) retirement savings plan with company matching, company-paid life insurance, and an array of additional perks including employee assistance and wellness programs. (Exact eligibility and coverage details vary by role and employment status.)Job SummaryIn 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 actionIdentifies barriers to efficient departmental operations related to self-pay billing/trends in insurance denial and takes an active role in developing appropriate solutionsactively works daily work queue and clearing house denialsAssists 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, etcReviews 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 mannerUses a patient-centric approach to answer questions and provide information in a professional mannerUnderstand all payer regulations to effectively communicate with patients about charges, payments and adjustments on their accountInvestigate patient inquiries/disputes surrounding charging, coding, payments, locations, services, insurance coverage, etcWorks with individuals when appropriate at various levels of the organization to find resolution on patient disputesUpdates account information (addresses, insurance, etc.) and rebills as appropriate to initiate the next steps in the billing and collection cycleQualifications: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. Bachelor's Degree PreferredCommunicate effectively and work directly with third parties (insurance payers, patients, internal departments, vendors, leadership, etc.) to relay updates on patient accounts timelyAbility to read and write in English is requiredOrganize and articulate account disputes, and written letters of appealExcellent customer service and communication as well as interpersonal, organizational and analytical skillsProficient in Office Applications (e.g. Excel, Word, Google Sheets, Google Mail)Comprehensive knowledge of Professional and/or Hospital revenue cycleAbility to work in a high volume setting and respond to insurance or patient inquiries in a timely mannerAbility to identify and communicate payer trends and/or system trendsAbility to navigate payer websitesKnowledge of payer contracts, regulations and guidelines, as well as State and Federal laws relating to billing, collection, and financial assistance procedures preferredFamiliar with medical and insurance terminologyProficient in the use of a computer and relevant hospital software applications e.g., Meditech and/or eClinicalWorksUnderstanding and adherence to HIPAA Regulations and Release of Information RulesModels teamwork through cooperation and collaboration within and outside the work groupAbility to attain productivity and quality standards per department requirementsState/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.