Billing Specialist jobs at Perception Programs

Primary Location: Connecticut-Torrington-65 Commercial Blvd Torrington (10413) Job: Health ProfessionalsOrganization: Hartford HealthCare at HomeJob Posting: Dec 5, 2025 Pre-Billing Specialist (Office, Billing, Finance) - HomeCare - (25165596) Description Work where every moment matters. Every day, over 40,000 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 as a Pre-Billing Specialist. The Pre-Billing Specialist is responsible for reviewing and validating clinical documentation and billing data within the Homecare Homebase (HCHB) system prior to claim submission. This role ensures compliance with Medicare, Medicaid, and other Commercial payer requirements, helping to prevent billing errors and reduce denials. This position works closely with clinical, administrative, and billing teams to ensure accurate and timely revenue capture. Review patient charts in HCHB to ensure all required documentation is complete and compliant before billing. This includes:Validating visit frequencies, orders and care plans against billing requirements. Ensures that all disciplines have signed and locked note and that visits are properly scheduled and documented. Maintain up-to-date knowledge of payer guidelines and regulatory changes to ensure billing readiness for Medicare, Medicaid, and commercial payers, while also assisting in training staff on documentation and billing compliance best practices. Identify and resolve discrepancies or missing documentation that could delay billing, collaborating with clinical staff to obtain corrections or additional information as needed. Qualifications High school diploma, Bachelor's Degree PreferredExperience1 Year of Administrative Healthcare Experience, 2 years of experience in home health billing, auditing, or clinical documentation review PreferredKnowledge, Skills and Ability RequirementsThe Pre-Billing Specialist must have healthcare experience, preferably in a home health or hospice environment, and a strong working knowledge of auditing or clinical documentation review. Demonstrates good communication and excellent attention to details and organizational skills. Demonstrates autonomy, assertiveness, flexibility and cooperation in performing job responsibilities 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 colleagues-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment. RegularStandard Hours Per Week: 40Schedule: Full-time (40 hours) Shift Details: In-Person in the Torrington Office - Monday thru Friday 8am to 4:30pm

Work where every moment matters. Every day, over 40,000 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 as a Pre-Billing Specialist. The Pre-Billing Specialist is responsible for reviewing and validating clinical documentation and billing data within the Homecare Homebase (HCHB) system prior to claim submission. This role ensures compliance with Medicare, Medicaid, and other Commercial payer requirements, helping to prevent billing errors and reduce denials. This position works closely with clinical, administrative, and billing teams to ensure accurate and timely revenue capture. Review patient charts in HCHB to ensure all required documentation is complete and compliant before billing. This includes: Validating visit frequencies, orders and care plans against billing requirements. Ensures that all disciplines have signed and locked note and that visits are properly scheduled and documented. Maintain up-to-date knowledge of payer guidelines and regulatory changes to ensure billing readiness for Medicare, Medicaid, and commercial payers, while also assisting in training staff on documentation and billing compliance best practices. Identify and resolve discrepancies or missing documentation that could delay billing, collaborating with clinical staff to obtain corrections or additional information as needed. High school diploma, Bachelor's Degree Preferred Experience 1 Year of Administrative Healthcare Experience, 2 years of experience in home health billing, auditing, or clinical documentation review Preferred Knowledge, Skills and Ability Requirements The Pre-Billing Specialist must have healthcare experience, preferably in a home health or hospice environment, and a strong working knowledge of auditing or clinical documentation review. Demonstrates good communication and excellent attention to details and organizational skills. Demonstrates autonomy, assertiveness, flexibility and cooperation in performing job responsibilities 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 colleagues-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.

High school diploma, Bachelor's Degree Preferred Experience 1 Year of Administrative Healthcare Experience, 2 years of experience in home health billing, auditing, or clinical documentation review Preferred Knowledge, Skills and Ability Requirements The Pre-Billing Specialist must have healthcare experience, preferably in a home health or hospice environment, and a strong working knowledge of auditing or clinical documentation review. Demonstrates good communication and excellent attention to details and organizational skills. Demonstrates autonomy, assertiveness, flexibility and cooperation in performing job responsibilities 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 colleagues-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment. Work where every moment matters. Every day, almost 40,000 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 as a Pre-Billing Specialist. The Pre-Billing Specialist is responsible for reviewing and validating clinical documentation and billing data within the Homecare Homebase (HCHB) system prior to claim submission. This role ensures compliance with Medicare, Medicaid, and other Commercial payer requirements, helping to prevent billing errors and reduce denials. This position works closely with clinical, administrative, and billing teams to ensure accurate and timely revenue capture. Review patient charts in HCHB to ensure all required documentation is complete and compliant before billing. This includes: Validating visit frequencies, orders and care plans against billing requirements. Ensures that all disciplines have signed and locked note and that visits are properly scheduled and documented. Maintain up-to-date knowledge of payer guidelines and regulatory changes to ensure billing readiness for Medicare, Medicaid, and commercial payers, while also assisting in training staff on documentation and billing compliance best practices. Identify and resolve discrepancies or missing documentation that could delay billing, collaborating with clinical staff to obtain corrections or additional information as needed.

Job Details BHI Bristol Hospital Main Campus - Bristol, CT Part Time High School 2nd Shift (Evenings) 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. Job Summary: Bristol Health is looking for Patient Information Representatives. In this role, you will be the first point of contact for patients, visitors, and staff, providing essential information and assistance. Your exceptional communication skills and friendly demeanor will contribute to creating a welcoming and helpful environment for all individuals entering our hospital Essential Job Functions and Responsibilities: Greet and welcome patients, visitors, and staff as they enter the hospital Creation of visitor badges by running patient and / or visitor identification through badging system Provide accurate and up-to-date information regarding hospital services, departments, and directions Assist patients and visitors in locating their desired destinations within the hospital Answer phone calls and respond to inquiries, providing information or directing calls to the appropriate departments or personnel Maintain a neat and organized information desk area, ensuring that brochures, maps, and other informational materials are readily available Coordinate with other hospital staff to ensure smooth patient flow and address any concerns or issues promptly Handle complaints or difficult situations with professionalism and empathy, escalating matters to the appropriate individuals when necessary Maintain confidentiality and adhere to privacy regulations when handling patient information Stay updated on hospital policies, procedures, and safety protocols Notifies support services (EVS, Engineering, etc) when their attention is required. Qualifications Qualifications: This position requires the ability to multitask, handle inquiries efficiently, and always maintain a professional and courteous attitude High school diploma or equivalent Excellent verbal and written communication skills Strong interpersonal skills and the ability to interact effectively with individuals from diverse backgrounds Proficiency in using computer systems and basic office software Exceptional problem-solving skills and the ability to remain calm under pressure Bristol Health Mandated Educational Requirements: General orientation at time of hire. Fire/Safety/Infection Control annually. Similar programs deemed appropriate by management. Ongoing leadership training. Physical Requirements: Manual dexterity. Vision corrected to comply with State of CT driver's license standards. Capable of hearing and verbally communicating. Work Environment: Normal patient care environment. Cognitive Requirements: Mental flexibility to perform diverse duties. Good communications skills, written and oral and ability to follow written and oral instructions. Able to remain calm and make appropriate decisions in emergency situations. Good organizational skills along with basic computer skills. 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.

Edgehill, premier CCRC in Stamford, CT, is seeking a full time SNF Medicare Biller for our Boutique Skilled Nursing neighborhood, with an average census of 40 residents, luxury amenities, high RN, LPN and CNA staffing ratio (best in class) and full administrative support staff. The Medicare Biller is responsible for the capture, billing, adjustment, and collection of all charges generated by the Edgehill Skilled Nursing Facility, and outpatient medical charges. Responsibilities and Competencies Proficiency with Microsoft Windows software, including Excel, Word, and Outlook. Proficiency with claims management software systems. Distribution of Self-Pay invoices to residents to insure timely collections. 2 Years of current Medicare, Managed Care and Long-Term Care (LTC) experience required Experience with Medicare, and Medicare & Commercial HMO/PPO billing guidelines and rules, insurance reimbursement methods, and the claims appeal process. Knowledge of and ability to follow insurance carrier guidelines in order to ensure that Electronic Data Interface and paper claims are submitted with proper documentation, consent form, referral and/or authorization as needed. Ability to review & interpret insurance Explanation of Benefits & Electronic Remittance Advices to determine & identify reasons for claim denial, and when appropriate, appeal course of action for resolution. Able to identify potential problem trends such as incorrect coding or down coding, and carrier non-payment trends. Ability to communicate effectively both written and verbal. QUALIFICATIONS Medicare Part A & B billing experience in a skilled nursing facility is preferred. College Degree in a relevant course preferred. At least 2 years of business office/financial experience.

Fair Haven Community Health Care For over 54 years, FHCHC has been an innovative and vibrant community health center, catering to multiple generations with over 165,000 office visits across 21 locations. Guided by a Board of Directors, most of whom are patients themselves, we take pride in being a healthcare leader dedicated to delivering high-quality, affordable medical and dental care to everyone, regardless of their insurance status or ability to pay. Our extensive range of primary and specialty care services, along with evidence-based programs, empowers patients to make informed choices about their health. As we expand our reach to underserved areas, our commitment to prioritizing patient needs remains unwavering. FHCHC's mission is to enhance the health and social well-being of the communities we serve through equitable, high-quality, and culturally responsive patient-centered care. Job purpose Fair Haven prides itself on efficient billing services including the filing of claims, appeals processing, authorizations, and, above all, a great passion for helping individuals obtain treatment. The Billing Specialist/Dental Authorization Coordinator works with the Billing and Dental department verifying benefits for patients and ensuring benefits quoted are accurate and detailed. Duties and responsibilities The Billing Specialist/ Dental Authorization Coordinator maintains the professional reimbursement and collections process for the dental program. Typical duties include but are not limited to: Billing * Performs billing and computer functions, including data entry, documentation review and encounter posting * Prepares and submits clean claims to various insurance companies either electronically or by paper when necessary * Work claims and claim denials to ensure maximum reimbursement for services provided Carrier Authorizations * Verifying patients' insurance and obtaining coverage breakdowns * Creating ABNs as needed based on coverage * Schedule/treatment plan reviews for carrier authorization * Obtaining and logging prior authorizations for procedures as mandated by carriers. Collections (Self-pay) * Prepare, review and send patient statements * Process and send "collections" letters for outstanding balances * Process all returned mail * Answer incoming patient billing phone calls, work to resolve patient issues * Initiating collection calls and setting up and maintaining payment arrangements * Follow collections process as outlined in FHCHC billing guideline Qualifications High School diploma or GED is required. Experience in a dental setting is essential. The ideal candidate will have a minimum of one year of dental authorizations and billing experience; excellent Interpersonal skills, accuracy and attention to detail a must. The selected candidate will have the ability to work in a team environment or independently; to meet all established deadlines, metrics and assignment goals at all times and have oral and written proficiency in English. Bi-lingual in English and Spanish is highly preferred. He/she must be able to use computer and multi-lined telephones; have an understanding of dental terminology and knowledge and experience in billing and authorization practices specific to Medicaid. Please note candidates must be able to commute to our New Haven and Branford, Connecticut Offices. American with Disabilities Requirements: External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis. Fair Haven Community Health Care is an Equal Opportunity Employer. FHCHC does not discriminate on the basis of race, religion, color, sex, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.

Job Description Fair Haven Community Health Care For over 54 years, FHCHC has been an innovative and vibrant community health center, catering to multiple generations with over 165,000 office visits across 21 locations. Guided by a Board of Directors, most of whom are patients themselves, we take pride in being a healthcare leader dedicated to delivering high-quality, affordable medical and dental care to everyone, regardless of their insurance status or ability to pay. Our extensive range of primary and specialty care services, along with evidence-based programs, empowers patients to make informed choices about their health. As we expand our reach to underserved areas, our commitment to prioritizing patient needs remains unwavering. FHCHC's mission is to enhance the health and social well-being of the communities we serve through equitable, high-quality, and culturally responsive patient-centered care. Job purpose Fair Haven prides itself on efficient billing services including the filing of claims, appeals processing, authorizations, and, above all, a great passion for helping individuals obtain treatment. The Billing Specialist/Dental Authorization Coordinator works with the Billing and Dental department verifying benefits for patients and ensuring benefits quoted are accurate and detailed. Duties and responsibilities The Billing Specialist/ Dental Authorization Coordinator maintains the professional reimbursement and collections process for the dental program. Typical duties include but are not limited to: Billing Performs billing and computer functions, including data entry, documentation review and encounter posting Prepares and submits clean claims to various insurance companies either electronically or by paper when necessary Work claims and claim denials to ensure maximum reimbursement for services provided Carrier Authorizations Verifying patients' insurance and obtaining coverage breakdowns Creating ABNs as needed based on coverage Schedule/treatment plan reviews for carrier authorization Obtaining and logging prior authorizations for procedures as mandated by carriers. Collections (Self-pay) Prepare, review and send patient statements Process and send “collections” letters for outstanding balances Process all returned mail Answer incoming patient billing phone calls, work to resolve patient issues Initiating collection calls and setting up and maintaining payment arrangements Follow collections process as outlined in FHCHC billing guideline Qualifications High School diploma or GED is required. Experience in a dental setting is essential. The ideal candidate will have a minimum of one year of dental authorizations and billing experience; excellent Interpersonal skills, accuracy and attention to detail a must. The selected candidate will have the ability to work in a team environment or independently; to meet all established deadlines, metrics and assignment goals at all times and have oral and written proficiency in English. Bi-lingual in English and Spanish is highly preferred. He/she must be able to use computer and multi-lined telephones; have an understanding of dental terminology and knowledge and experience in billing and authorization practices specific to Medicaid. Please note candidates must be able to commute to our New Haven and Branford, Connecticut Offices. American with Disabilities Requirements: External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis. Fair Haven Community Health Care is an Equal Opportunity Employer. FHCHC does not discriminate on the basis of race, religion, color, sex, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need. Powered by JazzHR aGfmaEIAFE

We Did It Again! InterCommunity is a 2025 Healthcare Top Workplaces Winner! VOTED by our incredible staff a TOP WORKPLACE for 12 YEARS - including 2025! Join a Mission That Matters InterCommunity, Inc. is a Federally Qualified Health Center Look-Alike (FQHC LA) committed to providing accessible, compassionate care to everyone - regardless of life situation or ability to pay. We offer same-day primary care and a wide range of behavioral health services across our community health centers in: 281 Main St., East Hartford 40 Coventry St., Hartford 828 Sullivan Ave., South Windsor Our Addiction Services Division provides a full continuum of care, including: Primary care integration Residential detox and treatment Outpatient mental health and substance use services for adults and children Intensive outpatient programs Employment and community support Mobile crisis evaluations Judicial support services Social rehabilitation Why Work With Us? At InterCommunity, we believe your well-being matters - at work and beyond. That's why we offer a comprehensive benefits package designed to support your health, financial security, and work-life balance. All benefit- eligible employees of InterCommunity are eligible for Medical, Dental, Voluntary Vision, Group Life, Supplemental Life, Short-Term Disability and Long-Term Disability. (A benefit -eligible employee is one who is schedule to work a minimum of 30 hours per week.). In addition, all employees may contribute to our 401k and those who meet eligibility and service requirements will receive the company contribution. Benefits are effective on the first day of the month following date of hire. Our Benefits Include: Work Life-Balance-Flexibility, generous Paid PTO, and paid holidays. Health & Dental insurance - flexible contribution options that includes 2 HDHP w/ HSA enrollment option or non-HDHP at a minimal cost to employees. Voluntary vision coverage. Employer-paid Short-Term Disability, Long-Term Disability, and Basic Life & AD&D. Supplemental Life Insurance available. 401(k) with 3% employer match + 3% employer contribution after 12 months and 1,000 hours worked Career advancement opportunities in a supportive, mission-driven environment. Summary: Services will be entered by the Billing Specialist, but all checks will be done in the AR department. Additionally, follow up of unpaid client accounts and general filing and other office duties will be needed. Essential Duties & Responsibilities: Researches any overdue account balance that is fully or partially unpaid and follows up by mail and/or phone to insurance carriers or customers on delinquent payments. Reviews claims denied for payment and underpaid claims. Responds to customer inquiries regarding account status. Researches customer's accounts thoroughly and documents appropriately. Resolves discrepancies and prepares adjustments and refunds as necessary. Brings recurring issues to the attention of the department supervisor. Initiates bills and resubmits bills as necessary. Pursues patient for payment obligations when insurance defaults as permitted by law or contractual relationships. Receives and processes payments and denial of payments. Separates payments into batches. Posts payments to accounts according to the service dates to ensure accurate payment status and accurate account activity. Prepares completed cash batches for filing. Prepares and posts adjustment to appropriate accounts as necessary. Processes refunds immediately to the government if overpayments have occurred. Demonstrates professional etiquette and courtesy when interfacing with customers. Resolves patient/customer complaints by identifying problems and coordinating appropriate corrective action. Performs timely follow-up on Initial and renewal authorizations to maintain reimbursement activity. Ensures that payor changes are completed accurately, payment is guaranteed and revenue is recorded appropriately. Verifies that the correct payor is tied to the service/therapy and ensures that the correct allowable is recorded in accordance with the contract. Contacts payor /insurers to verify insurance coverage and eligibility requirement of patients that are changing payors. Obtain verbal /written authorization for medical treatment from appropriate sources. Verifies insurance information for accuracy and completeness and resolves discrepancies as necessary. Documents all account activity in system. Perform internal quality audits to ensure that all necessary documentation is included in each patient file. Requests adjustments on accounts and recommends necessary changes to supervisor. Performs other related duties as required. *All agency staff are required to attend all mandatory department/agency meetings and trainings* Schedule: Monday - Friday, 8:00 AM - 4:30 PM Requirements Education &/Or Experience: Associate's degree or equivalent from two-year college or technical school; Two (2) years related experience and/or training; or equivalent combination of education and experience. Knowledge of claim/billing process. Knowledge of various insurance plans, entitlement programs and their claim procedures. Competencies: Initiative Leadership Time management Decision making Communication proficiency (Verbal & Written) Technology & computer literacy (Microsoft Word, keyboarding) Organization skills Salary Description Wage Range: $21.25 - $25.00 Hourly

Full-time Description We Did It Again! InterCommunity is a 2025 Healthcare Top Workplaces Winner! VOTED by our incredible staff a TOP WORKPLACE for 12 YEARS - including 2025! Join a Mission That Matters InterCommunity, Inc. is a Federally Qualified Health Center Look-Alike (FQHC LA) committed to providing accessible, compassionate care to everyone - regardless of life situation or ability to pay. We offer same-day primary care and a wide range of behavioral health services across our community health centers in: 281 Main St., East Hartford 40 Coventry St., Hartford 828 Sullivan Ave., South Windsor Our Addiction Services Division provides a full continuum of care, including: Primary care integration Residential detox and treatment Outpatient mental health and substance use services for adults and children Intensive outpatient programs Employment and community support Mobile crisis evaluations Judicial support services Social rehabilitation Why Work With Us? At InterCommunity, we believe your well-being matters - at work and beyond. That's why we offer a comprehensive benefits package designed to support your health, financial security, and work-life balance. All benefit- eligible employees of InterCommunity are eligible for Medical, Dental, Voluntary Vision, Group Life, Supplemental Life, Short-Term Disability and Long-Term Disability. (A benefit -eligible employee is one who is schedule to work a minimum of 30 hours per week.). In addition, all employees may contribute to our 401k and those who meet eligibility and service requirements will receive the company contribution. Benefits are effective on the first day of the month following date of hire. Our Benefits Include: Work Life-Balance-Flexibility, generous Paid PTO, and paid holidays. Health & Dental insurance - flexible contribution options that includes 2 HDHP w/ HSA enrollment option or non-HDHP at a minimal cost to employees. Voluntary vision coverage. Employer-paid Short-Term Disability, Long-Term Disability, and Basic Life & AD&D. Supplemental Life Insurance available. 401(k) with 3% employer match + 3% employer contribution after 12 months and 1,000 hours worked Career advancement opportunities in a supportive, mission-driven environment. Summary: Services will be entered by the Billing Specialist, but all checks will be done in the AR department. Additionally, follow up of unpaid client accounts and general filing and other office duties will be needed. Essential Duties & Responsibilities: Researches any overdue account balance that is fully or partially unpaid and follows up by mail and/or phone to insurance carriers or customers on delinquent payments. Reviews claims denied for payment and underpaid claims. Responds to customer inquiries regarding account status. Researches customer's accounts thoroughly and documents appropriately. Resolves discrepancies and prepares adjustments and refunds as necessary. Brings recurring issues to the attention of the department supervisor. Initiates bills and resubmits bills as necessary. Pursues patient for payment obligations when insurance defaults as permitted by law or contractual relationships. Receives and processes payments and denial of payments. Separates payments into batches. Posts payments to accounts according to the service dates to ensure accurate payment status and accurate account activity. Prepares completed cash batches for filing. Prepares and posts adjustment to appropriate accounts as necessary. Processes refunds immediately to the government if overpayments have occurred. Demonstrates professional etiquette and courtesy when interfacing with customers. Resolves patient/customer complaints by identifying problems and coordinating appropriate corrective action. Performs timely follow-up on Initial and renewal authorizations to maintain reimbursement activity. Ensures that payor changes are completed accurately, payment is guaranteed and revenue is recorded appropriately. Verifies that the correct payor is tied to the service/therapy and ensures that the correct allowable is recorded in accordance with the contract. Contacts payor /insurers to verify insurance coverage and eligibility requirement of patients that are changing payors. Obtain verbal /written authorization for medical treatment from appropriate sources. Verifies insurance information for accuracy and completeness and resolves discrepancies as necessary. Documents all account activity in system. Perform internal quality audits to ensure that all necessary documentation is included in each patient file. Requests adjustments on accounts and recommends necessary changes to supervisor. Performs other related duties as required. *All agency staff are required to attend all mandatory department/agency meetings and trainings* Schedule: Monday - Friday, 8:00 AM - 4:30 PM Requirements Education &/Or Experience: Associate's degree or equivalent from two-year college or technical school; Two (2) years related experience and/or training; or equivalent combination of education and experience. Knowledge of claim/billing process. Knowledge of various insurance plans, entitlement programs and their claim procedures. Competencies: Initiative Leadership Time management Decision making Communication proficiency (Verbal & Written) Technology & computer literacy (Microsoft Word, keyboarding) Organization skills Salary Description Wage Range: $21.25 - $25.00 Hourly

Job Description Billing Specialist Masonicare Corporate Services - Wallingford, CT Day Shift / 40hrs/wk IS ON-SITE** Under general supervision from Patient Accounts Management, The Billing Specialist performs a variety of complex operations related to the eligibility, claim preparation, claim submission, suspense resolution, claim follow up and credit balance adjudication/reporting for healthcare services provided to Medicare, Medicaid and Commercial Primary/Secondary beneficiaries. Submits third party claims and resolves billing, payment and collection issues. Essential Duties and Responsibilities: - Review-reports to identify claims that are eligible for billing to intermediaries, insurance companies, third parties and patients. Processes claims and bills in Electronic Medical Record (EMR) system following established procedures. - Works with - operations to resolve - issues that impact claims processing. Brings problems and delinquent responses to the attention of Manager. Process- corrections - and generate- claims for re-processing. - - Reviews denials and zero pay claims from payor remittance advices, research issues and prepare-claims for resubmission. - Monitors unpaid claims via accounts receivable -aging, initiate- timely follow up calls and resubmit- claims and/or supporting information to receive- payment from payor. Work- under the direction of Manager to oversee timely collection- - -. - Maintains detailed claim history in collections database. Maintains statistical data and records. May prepare regularly scheduled or special reports on claims, suspense, denials, credit balances and payment activity. - Responds by telephone or correspondence to inquiries from patients, family, intermediaries or payers. Explain benefit coverage to patients, research- problems and correct-errors. - Identifies and investigates problem delinquencies; follow through with collection policy prior to referral to collection agency, legal action, or write off. - Meet- defined productivity metrics set up by Manager and maintain- - high-quality standards - -. - May assist in preparing documentation for appeals, third party audits, legal inquiries, litigation, and court appearances. Assists in special projects as needed. Perform general clerical duties to support the -team. - Work as a -cross-functional team member b=by providing training to others and -furthering training in our current systems as -appropriate. -Assist in documenting step-by-step task process- for each task and maintain a process manual at workstation. - Follows established departmental policies, procedures and objectives. - Performs miscellaneous job-related duties as assigned. Minimum Qualifications: Education: High School Diploma or GED Experience: 1 to 3 years' experience in healthcare billing. Day Shift / 40hrs/wk

Fair Haven Community Health Care For over 54 years, FHCHC has been an innovative and vibrant community health center, catering to multiple generations with over 165,000 office visits across 21 locations. Guided by a Board of Directors, most of whom are patients themselves, we take pride in being a healthcare leader dedicated to delivering high-quality, affordable medical and dental care to everyone, regardless of their insurance status or ability to pay. Our extensive range of primary and specialty care services, along with evidence-based programs, empowers patients to make informed choices about their health. As we expand our reach to underserved areas, our commitment to prioritizing patient needs remains unwavering. FHCHC's mission is to enhance the health and social well-being of the communities we serve through equitable, high-quality, and culturally responsive patient-centered care. Job purpose To provide timely, detailed accurate full patient registration prior to the patient's visit, either via telephone or in person to assure an exceptional patient experience. This individual maintains a patient-focused approach towards operational excellence while working as an integral part of the health care team. Duties and responsibilities The Pre-Registration Specialist performs timely, detailed, accurate full patient registration and maintains the integrity of the demographic information of the patient, insured, guarantor and insurance company as well as all additional information required for reporting. Typical duties include but are not limited to: * Obtain and verify patient demographic and guarantor information prior to visits to ensure that the patient record is accurate and is available for billing purposes. * Obtain patient insurance information and verify the patient's eligibility, whether via phone, web-site or electronic eligibility checks. * Obtain and verify patient information required for reporting purposes prior to visits. * Work queues/listings to determine which patients require pre-registration 1-7 days prior to their upcoming appointment. * Contact patients via telephone to obtain needed information. * Answer all incoming phone calls in a timely manner demonstrating good customer service. * Obtain benefits to aid in payment collections at time of service. * Provide accurate information to patients about insurance requirements. * Complete all necessary questionnaires when needed for upcoming appointments. * Ensure that the proper steps are taken to eliminate patients from pre-registration status and communicate with Patient Access what is needed at the check in process. * Ability to provide information to patients regarding FHCHC services and directions to various locations. * Maintain and adhere to HIPAA privacy policies * Performs other duties as assigned and providing coverage for departments under operations portfolio (i.e. front desk) as necessary, including extended leaves Qualifications * High School diploma or GED with experience in medical billing is required. Bi-lingual in English and Spanish is also required. Excellent interpersonal and communication skills and ability to work as a member of the team to serve the patients is essential. * The selected candidate must be detail oriented and have the ability to work independently with one year of experience demonstrating customer service highly preferred. Epic experience is desirable. * Must be willing to work in various locations and various shifts Physical Requirements/Work Environment * Must have manual dexterity to operate keyboards, telephones and other business equipment * Position requires the use of a headset and the ability to sit for extended periods of time * High volume of calls each day. * Medical office type environment. Works closely with co-workers daily American with Disabilities Requirements: External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis. Fair Haven Community Health Care is an Equal Opportunity Employer. FHCHC does not discriminate on the basis of race, religion, color, sex, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.

Job Description Fair Haven Community Health Care For over 54 years, FHCHC has been an innovative and vibrant community health center, catering to multiple generations with over 165,000 office visits across 21 locations. Guided by a Board of Directors, most of whom are patients themselves, we take pride in being a healthcare leader dedicated to delivering high-quality, affordable medical and dental care to everyone, regardless of their insurance status or ability to pay. Our extensive range of primary and specialty care services, along with evidence-based programs, empowers patients to make informed choices about their health. As we expand our reach to underserved areas, our commitment to prioritizing patient needs remains unwavering. FHCHC's mission is to enhance the health and social well-being of the communities we serve through equitable, high-quality, and culturally responsive patient-centered care. Job purpose To provide timely, detailed accurate full patient registration prior to the patient's visit, either via telephone or in person to assure an exceptional patient experience. This individual maintains a patient-focused approach towards operational excellence while working as an integral part of the health care team. Duties and responsibilities The Pre-Registration Specialist performs timely, detailed, accurate full patient registration and maintains the integrity of the demographic information of the patient, insured, guarantor and insurance company as well as all additional information required for reporting. Typical duties include but are not limited to: Obtain and verify patient demographic and guarantor information prior to visits to ensure that the patient record is accurate and is available for billing purposes. Obtain patient insurance information and verify the patient's eligibility, whether via phone, web-site or electronic eligibility checks. Obtain and verify patient information required for reporting purposes prior to visits. Work queues/listings to determine which patients require pre-registration 1-7 days prior to their upcoming appointment. Contact patients via telephone to obtain needed information. Answer all incoming phone calls in a timely manner demonstrating good customer service. Obtain benefits to aid in payment collections at time of service. Provide accurate information to patients about insurance requirements. Complete all necessary questionnaires when needed for upcoming appointments. Ensure that the proper steps are taken to eliminate patients from pre-registration status and communicate with Patient Access what is needed at the check in process. Ability to provide information to patients regarding FHCHC services and directions to various locations. Maintain and adhere to HIPAA privacy policies Performs other duties as assigned and providing coverage for departments under operations portfolio (i.e. front desk) as necessary, including extended leaves Qualifications High School diploma or GED with experience in medical billing is required. Bi-lingual in English and Spanish is also required. Excellent interpersonal and communication skills and ability to work as a member of the team to serve the patients is essential. The selected candidate must be detail oriented and have the ability to work independently with one year of experience demonstrating customer service highly preferred. Epic experience is desirable. Must be willing to work in various locations and various shifts Physical Requirements/Work Environment Must have manual dexterity to operate keyboards, telephones and other business equipment Position requires the use of a headset and the ability to sit for extended periods of time High volume of calls each day. Medical office type environment. Works closely with co-workers daily American with Disabilities Requirements: External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis. Fair Haven Community Health Care is an Equal Opportunity Employer. FHCHC does not discriminate on the basis of race, religion, color, sex, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need. Powered by JazzHR gCFK2jR24T

Current Saint Francis Employees - Please click HERE to login and apply. This position is ECB status - requires a minimum number of worked hours per month as needed by the department; limited benefit offerings. Days Shift: ECB (Emergency Call Basis) Fridays, Saturdays & Sundays 7:00am - 3:30pm @ Main Entrance Job Summary: The Patient Family Representative is responsible for greeting patients, families and visitors arriving at the hospital and coordinating communications between hospital staff, patients and their families; serving as an information provider. Minimum Education: High School Diploma or GED. Licensure, Registration and/or Certification: None. Work Experience: 1 - 2 years related experience Knowledge, Skills and Abilities: Advanced computer skills, including Word, Excel and Windows. Proficient with the use of Outlook. Excellent interpersonal skills required. Ability to work with minimal supervision. Ability to demonstrate excellent customer service skills. Essential Functions and Responsibilities: Greet patients, families and visitors arriving at the hospital. Works closely with volunteers to ensure that the patient's, families and visitors needs are met. Directs the escorting of the patients, families and visitors by the volunteers throughout the hospital. Information provider for patients, families and visitors. Coordinate communications between hospital staff, patients and their families. Decision Making: Independent judgment in making minor decisions where alternatives are limited and standard policies/protocols have been established. Working Relationships: Works directly with patients and/or customers. Works with internal customers via telephone or face to face interaction. Works with external customers via telephone or face to face interaction. Works with other healthcare professionals and staff. Special Job Dimensions: None. Supplemental Information: This document generally describes the essential functions of the job and the physical demands required to perform the job. This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties. Security - Yale Campus Location: Tulsa, Oklahoma 74136 EOE Protected Veterans/Disability

Current Saint Francis Employees - Please click HERE to login and apply. This position is ECB status - requires a minimum number of worked hours per month as needed by the department; limited benefit offerings. Variable Shift: Mon, Tues, Wed, Thurs 3pm-7pm; Saturday 7:30am-4pm Job Summary: Schedules procedures, verifies and inputs patient demographic and insurance/financial information, and creates new patient medical records for the purpose of facilitating the effective delivery of patient care. Minimum Education: High School Diploma or GED. Licensure, Registration and/or Certification: None. Work Experience: 6 months to 1 year related experience. Knowledge, Skills and Abilities: Effective interpersonal and oral communication skills. Ability to organize and prioritize work in an effective and efficient manner. Ability to be detail-oriented as might be required in the examination of numerical data. Essential Functions and Responsibilities: Schedules procedures according to established protocols including obtaining and documenting complete patient demographic and insurance/financial information. Confirms scheduled appointments. Creates new patient medical records. Prints and files reports and other correspondence according to established protocols. Serves as liaison to referring physician offices, other outreach hospitals, patients, and patient family members in an effort to provide a single point of contact. Greets and prepares patients for physician consults according to established protocols. Decision Making: Independent judgment in making minor decisions where alternatives are limited and standard policies/protocols have been established. Working Relationships: Works directly with patients and/or customers. Works with internal customers via telephone or face to face interaction. Works with external customers via telephone or face to face interaction. Works with other healthcare professionals and staff. Special Job Dimensions: None. Supplemental Information: This document generally describes the essential functions of the job and the physical demands required to perform the job. This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties. Breast Center - Yale Campus Location: Tulsa, Oklahoma 74136 EOE Protected Veterans/Disability

Connecticut Children's is the only health system in Connecticut that is 100% dedicated to children. Established on a legacy that spans more than 100 years, Connecticut Children's offers personalized medical care in more than 30 pediatric specialties across Connecticut and in two other states. Our transformational growth establishes us as a destination for specialized medicine and enables us to reach more children in locations that are closer to home. Our breakthrough research, superior education and training, innovative community partnerships, and commitment to diversity, equity and inclusion provide a welcoming and inspiring environment for our patients, families and team members. At Connecticut Children's, treating children isn't just our job - it's our passion. As a leading children's health system experiencing steady growth, we're excited to expand our team with exceptional team members who share our vision of transforming children's health and well-being as one team. The Revenue Cycle AR Specialist I is responsible for resolving insurance balances, following up with payors, and submitting appeals and reconsideration requests on rejected and denied claims. Education and/or Experience Required: * Education: * High School Diploma, GED, or a higher level of education that would require the completion of high school. * Experience: * Minimum 1 year completed experience in a Healthcare Revenue Cycle role. Education and/or Experience Preferred: * Education: * Associate's Degree in Healthcare Management, Finance, or related field. * Experience: * Experience with Epic * Patient billing experience preferred. License and/or Certifications Required: N/A * Accurately and compliantly resolves insurance balances after payment or adjudication, and correctly identifies any patient liability (i.e., contractual/payment review, etc.) and ensures accurate resolution of account to payment or payor terms; * Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites. * Leverages available resources and systems (both internal and external) to analyze patient accounting information and take appropriate action for payment resolution; documents all activity in accordance with organization and payor policies. * Coordinate appeal when claim is denied. May partner with medical care team members on complex appeals. * Submits LOMN (Letter of Medical Necessity) and other drafted appeals and reconsiderations on rejected and denied claims. * Sends appeals to payors, and follow up to ensure payment is made. * Continue to review acct and escalate as necessary if denial is not overturned. * Engages the CFC, UR, Revenue integrity or coding follow-up team for any medical necessity, auth. or coding related denials review. * Sets follow-up activities based on status of the claim; ensure full and clear account documentation on account status within system. * Collaborate as a part of a team on special projects by utilizing excel spreadsheets, and effectively communicate results Performs other job-related duties as assigned.

CPT Certification 1 year of Patient Care Technician experience required

Join a Team That Makes a Difference at Optimus Health Care! Are you passionate about providing high-quality, patient-centered care? Optimus Health Care-the largest provider of primary health care services in Fairfield County-is looking for dedicated professionals to join our team! With multiple locations in Bridgeport, Stratford, and Stamford, our mission is to be a lifelong health care partner, dedicated to achieving optimal wellness for the communities we serve. Optimus Healthcare is looking for a fulltime account receivable specialist with a minimum of two years of healthcare experience to join our team in Stratford, CT POSITION SUMMARY: Responsible for performing all tasks related to the billing, cash posting, follow-up, charge review, self-pay, and collections functions for Optimus Health Care. ESSENTIAL FUNCTIONS & RESPONSIBILITIES 1. Research all information needed to complete billing processing including correction of prebilling errors to ensure compliance with regulatory guidelines at time of billing. 2. Review of claim batches, making appropriate corrections for claims to be accepted by clearing house. 3. File all claims daily (electronic claims and hard copy). 4. Post charges and any corrections to charges to ensure integrity of account information. 5. Analyze billing reports to ensure proper billing procedures are followed based on federal and state rules and regulations. 6. Review and analyze health care clinicians claims and identify trends and issues within the revenue cycle process. 7. Post all insurance and patient payments received and reconcile to the door sheet provided by finance each day. 8. Research and resolve all collection related activities, including working through accounts receivables to maximize reimbursement. 9. Function as a liaison between patients and clinic staff on claims, billing questions or insurance related issues. 10. Trace errors, record adjustments to proper account and determine the appropriate destination of unidentified funds. 11. Respond to inquiries from agencies and insurance companies to assist in claim payment processing. 12. Effectively process all patient and third-party correspondence, including requests for copies of claims, statements, and refunds. 13. Effectively process all legal documentation as it relates to patient accounts. 14. Act as a resource to Clinicians, Administrators and patients regarding health insurance claim policies, procedures, and requirements. 15. Provide support to the Billing department and management team on various areas of patient billing research and analysis. 16. Research, trouble-shoot Accounts receivable reports and rejections, process appeals where appropriate, and make recommendation for write offs. 17. Maintain compliance according to government insurance regulations and managed care contractual obligations. 18. Maintain regulatory compliance by staying abreast of current trends and regulations in the financial and healthcare industries. 19. Maintain assigned work queues to ensure timely action for charge posting, insurance follow up, and credits. 20. Run standard billing reports from EMR for efficient and timely management of accounts receivables for insurance and patient collections. 21. Perform other duties and/or projects as assigned by the billing department management team. ADDITIONAL GENERAL REQUIREMENTS Professional positive attitude, vision, understanding of customer service principals, trustworthiness, and excellent communication and interpersonal skills to successfully accomplish tasks necessary to meet high standards of ethical and social responsibility required by this position. JOB QUALIFICATIONS/REQUIREMENTS * Detail-oriented with excellent problem-solving abilities * Experience with EMR (EPIC); Microsoft Word, Excel, PowerPoint, and other billing software applications * Strong communication, verbal and written and interpersonal skills * Ability to analyze and solve problems with limited assistance * Ability to maintain confidentiality * Demonstrated medical accounts receivable or insurance follow up background * Attention to detail and accuracy * Ability to meet deadlines * Strong organization and prioritization skills * Ability to work with a diverse group of people, providing excellent customer service * Ability to work independently or as a team member * Strong data entry Skills * Analytical and problem-solving skills EDUCATION: Associate or bachelor's degree in finance, Healthcare Administration, or a related field. Certified Professional Coder (CPC) or similar certification is desirable High School Diploma; (CPT4 and ICD9/ICD10), helpful. EXPERIENCE: Minimum of 2 years' experience in medical billing, accounts receivable, or a similar role. Proficient knowledge of medical terminology, ICD-10, and CPT codes. LANGUAGE SKILLS: English/Spanish helpful MATHEMATICAL SKILLS: Basic math skills REASONING ABILITY: Critical thinking, analytical and problem-solving skills. LICENSURE / CERTIFICATION: CCA or CPC certification Working for Optimus: * OHC provides a fun, fast-paced working environment, where our commitment to quality is present in every job function. * 100% Outpatient Setting * Excellent health & welfare benefit options * Competitive Compensation * Optimus and its caring, multilingual staff proudly serve our community in a patient-centered environment. Optimus is committed to providing equal employment opportunities to all applicants and employees as protected by applicable federal and/or state law.

Join a Team That Makes a Difference at Optimus Health Care! Are you passionate about providing high-quality, patient-centered care? Optimus Health Care-the largest provider of primary health care services in Fairfield County-is looking for dedicated professionals to join our team! With multiple locations in Bridgeport, Stratford, and Stamford, our mission is to be a lifelong health care partner, dedicated to achieving optimal wellness for the communities we serve. Optimus Healthcare is looking for a fulltime account receivable specialist with a minimum of two years of healthcare experience to join our team in Stratford, CT POSITION SUMMARY: Responsible for performing all tasks related to the billing, cash posting, follow-up, charge review, self-pay, and collections functions for Optimus Health Care. ESSENTIAL FUNCTIONS & RESPONSIBILITIES 1. Research all information needed to complete billing processing including correction of prebilling errors to ensure compliance with regulatory guidelines at time of billing. 2. Review of claim batches, making appropriate corrections for claims to be accepted by clearing house. 3. File all claims daily (electronic claims and hard copy). 4. Post charges and any corrections to charges to ensure integrity of account information. 5. Analyze billing reports to ensure proper billing procedures are followed based on federal and state rules and regulations. 6. Review and analyze health care clinicians claims and identify trends and issues within the revenue cycle process. 7. Post all insurance and patient payments received and reconcile to the door sheet provided by finance each day. 8. Research and resolve all collection related activities, including working through accounts receivables to maximize reimbursement. 9. Function as a liaison between patients and clinic staff on claims, billing questions or insurance related issues. 10. Trace errors, record adjustments to proper account and determine the appropriate destination of unidentified funds. 11. Respond to inquiries from agencies and insurance companies to assist in claim payment processing. 12. Effectively process all patient and third-party correspondence, including requests for copies of claims, statements, and refunds. 13. Effectively process all legal documentation as it relates to patient accounts. 14. Act as a resource to Clinicians, Administrators and patients regarding health insurance claim policies, procedures, and requirements. 15. Provide support to the Billing department and management team on various areas of patient billing research and analysis. 16. Research, trouble-shoot Accounts receivable reports and rejections, process appeals where appropriate, and make recommendation for write offs. 17. Maintain compliance according to government insurance regulations and managed care contractual obligations. 18. Maintain regulatory compliance by staying abreast of current trends and regulations in the financial and healthcare industries. 19. Maintain assigned work queues to ensure timely action for charge posting, insurance follow up, and credits. 20. Run standard billing reports from EMR for efficient and timely management of accounts receivables for insurance and patient collections. 21. Perform other duties and/or projects as assigned by the billing department management team. ADDITIONAL GENERAL REQUIREMENTS Professional positive attitude, vision, understanding of customer service principals, trustworthiness, and excellent communication and interpersonal skills to successfully accomplish tasks necessary to meet high standards of ethical and social responsibility required by this position. JOB QUALIFICATIONS/REQUIREMENTS • Detail-oriented with excellent problem-solving abilities • Experience with EMR (EPIC); Microsoft Word, Excel, PowerPoint, and other billing software applications • Strong communication, verbal and written and interpersonal skills • Ability to analyze and solve problems with limited assistance • Ability to maintain confidentiality • Demonstrated medical accounts receivable or insurance follow up background • Attention to detail and accuracy • Ability to meet deadlines • Strong organization and prioritization skills • Ability to work with a diverse group of people, providing excellent customer service • Ability to work independently or as a team member • Strong data entry Skills • Analytical and problem-solving skills EDUCATION: Associate or bachelor's degree in finance, Healthcare Administration, or a related field. Certified Professional Coder (CPC) or similar certification is desirable High School Diploma; (CPT4 and ICD9/ICD10), helpful. EXPERIENCE: Minimum of 2 years' experience in medical billing, accounts receivable, or a similar role. Proficient knowledge of medical terminology, ICD-10, and CPT codes. LANGUAGE SKILLS: English/Spanish helpful MATHEMATICAL SKILLS: Basic math skills REASONING ABILITY: Critical thinking, analytical and problem-solving skills. LICENSURE / CERTIFICATION: CCA or CPC certification Working for Optimus: • OHC provides a fun, fast-paced working environment, where our commitment to quality is present in every job function. • 100% Outpatient Setting * Excellent health & welfare benefit options • Competitive Compensation • Optimus and its caring, multilingual staff proudly serve our community in a patient-centered environment. Optimus is committed to providing equal employment opportunities to all applicants and employees as protected by applicable federal and/or state law.

Connecticut Children's is the only health system in Connecticut that is 100% dedicated to children. Established on a legacy that spans more than 100 years, Connecticut Children's offers personalized medical care in more than 30 pediatric specialties across Connecticut and in two other states. Our transformational growth establishes us as a destination for specialized medicine and enables us to reach more children in locations that are closer to home. Our breakthrough research, superior education and training, innovative community partnerships, and commitment to diversity, equity and inclusion provide a welcoming and inspiring environment for our patients, families and team members. At Connecticut Children's, treating children isn't just our job - it's our passion. As a leading children's health system experiencing steady growth, we're excited to expand our team with exceptional team members who share our vision of transforming children's health and well-being as one team. The Revenue Cycle AR Specialist II is responsible for resolving insurance balances, following up with payors, and submitting appeals and reconsideration requests on rejected and denied claims. Ensures claims are paid by insurance carrier to the organization correctly. Education and/or Experience Required: * Education: * High School Diploma, GED, or a higher level of education that would require the completion of high school. * Experience: * Minimum of 3 years Billing experience required in healthcare Rev Cycle with specialization in billing, account receivable follow up and denial management, with a High School Diploma/GED * OR * Minimum of 2 years direct experience with an Associate or Bachelors Education and/or Experience Preferred: * Education: * Associate's Degree in Healthcare Management, Finance, or related field. * Experience: * Experience with Epic License and/or Certification Required: N/A * Identifies root causes of insurance denials. Remains current with core knowledge of specific payer policies, contracts and administrative bulletins * Communicates identified payer trends such as denials for specific procedure, diagnosis codes, or other identified issues * Accurately and compliantly resolves insurance balances after payment or adjudication, and correctly identifies any patient liability (i.e., contractual/payment review, etc.) and ensures accurate resolution of account to payment or payor terms; * Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites. * Leverages available resources and systems (both internal and external) to analyze patient accounting information and take appropriate action for payment resolution; documents all activity in accordance with organization and payor policies. * Coordinate appeal when claim is denied. May partner with medical care team members on complex appeals. * Submits LOMN (Letter of Medical Necessity) and other drafted appeals and reconsiderations on rejected and denied claims. * Sends appeals to payors and follow up to ensure payment is made. * Continue to review acct and escalate as necessary if denial is not overturned. * Engages the CFC, UR, Revenue integrity or coding follow-up team for any medical necessity, auth. or coding related to denials review. * Sets follow-up activities based on status of the claim; ensure full and clear account documentation on account status within system. * Collaborate as a part of a team on special projects by utilizing excel spreadsheets, and effectively communicate results Performs other job-related duties as assigned.