Cust Svc Dispute Resol Analyst​/PA Customer Service

Cust Svc Dispute Resol Analyst / PA Customer Service

Location:

9 Farm Springs Rd, Farmington (10566)

Work where every moment matters. Every day, more than 40,000 Hartford Health Care 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.

The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.

With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.

The Customer Service Dispute Resolution Analyst is responsible for analysis, investigation and resolution of all customer service requests, system-wide requiring a second level review. This individual will assess the patient’s complaint from a holistic perspective, considering charging, billing, documentation, reimbursement, and posting, and work with other departments both within and outside of Revenue Cycle. The analyst must possess critical thinking skills to determine appropriate escalation to the next level for unresolved or outstanding cases, keeping all parties involved and updated throughout the research phase and upon final resolution.

Excellent communication skills are required for patient and colleague interaction, including de-escalation, empathy, compassion, and professionalism. The analyst will educate patients on billing intricacies and resulting balances. Experience across A/R, government and commercial insurance, federal and state regulations, self‑pay billing and collections, etc., is essential, as is initiative to research and resolve issues to completion on the patient’s behalf.

• Respond to calls, emails, and faxes related to patient billing in a timely and professional manner, using a patient‑centric approach.
• Understand healthcare billing and payer regulations to communicate effectively with patients about charges, payments and adjustments.
• Investigate and analyze patient inquiries/disputes surrounding charging, coding, payments, locations, services, insurance coverage, etc., and work with appropriate individuals across the organization to resolve disputes.
• Maintain a thorough, organized, updated electronic listing of dispute statuses, accessible to management at any time.
• Establish and maintain effective communication with departments essential to patient resolution, including Patient Relations, Privacy and Compliance, Risk Management, HIM, Charge, A/R Follow Up, Denials, Coding, Remit, Site Managers, Practice Managers, and vendors.
• Takes ownership of escalated patient complaints and their resolution, ensuring adherence to timely, compliant, and quality standards set by leadership.
• Directs inquiries to appropriate departments if not related to insurance and patient balances.
• Collaborate with the Customer Service Manager to identify trends, provide improved education, scripting, etc., to prevent similar situations and enhance patient experiences.
• Identify barriers to efficient departmental operations and proactively develop solutions using the H3W model.
• Must know Epic Navigation and all self‑pay workflows within the department; analyze associated accounts as needed.
• Research and update self‑pay accounts (process credits, return mail, bankruptcy, addresses, insurances, etc.), process financial assistance applications, and assist with Independence at Home billing.

This Job

Reports To:

Manager, Customer Service

• Minimum:
  Associate’s Degree
• Preferred:
  Bachelor’s Degree

• Minimum: 3‑5 years of experience in insurance and self‑pay billing, remit processing, patient access and/or collections.
• Preferred:
  Minimum 1 year of experience in a multi‑entity system with EPIC; prior experience in patient relations or customer service for a healthcare entity.