Enrollment & Billing Representative jobs in Hartford, CT

Enrollment & Billing Representative is responsible for the accurate enrollment and billing process for an insurance organization. Maintains related documents, updates corresponding records and responsible for enrollment and billing query. Being an Enrollment & Billing Representative requires a high school diploma or its equivalent. Typically reports to a supervisor or manager. The Enrollment & Billing Representative possesses a moderate understanding of general aspects of the job. Works under the close direction of senior personnel in the functional area. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)

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Sr. Billing & Coding Representative, Remote
  • Aledade
  • Hartford, CT FULL_TIME
  • Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care.


    We are searching for Sr. Billing Representatives to join the team. These team members are integral to the revenue cycle management team, acting as the subject matter experts for compliant claims submission, payer policies, and governmental regulations. This role aids several revenue cycle functions, accurate coding, timely claim submission, and denial management. 


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    Essential Duties & Responsibilities:
    • Conduct coding related pre-visit planning, post visit chart audits prior to claim submission, and query providers for identified discrepancies between claim documentation, ICD-10, and CPT Category I and II codes
    • Timely follow-up on claim denials, submission of corrected claims and written appeals, ongoing follow-up of appeal submissions
    • Utilize the accounts receivable aging report to resolve outstanding AR
    • Electronic claims submission according to payer contracts, governmental and/or third-party guidelines
    • Identify and alert management of denial trends and make recommendations for front-end edits to minimize reimbursement delays
    • Report data inconsistencies to management, Participate in regular team meetings, peer review activities, and departmental and organizational work groups as applicable
    • Adhere to productivity standards using key performance indicators (KPIs) and established healthcare billing metrics
    • Performs all job functions in compliance with applicable federal, state, and local laws and organizational policies and procedures
    • Other duties as assigned


    Required Skills/Abilities:
    • Comprehension of various types of insurance plans
    • Adaptability to perform in various electronic health records (EHRs) and practice management systems
    • Expert knowledge of risk coding in an Accountable Care Organization (ACO)
    • Expertise in applying payer policy, Local Coverage Determinations (LCDs), National Coverage determinations (NCDs), and National Correct Coding Initiatives (NCCIs)
    • Knowledge of CPT, ICD-10, and HCPC Level II coding guidelines
    • Ability to navigate healthcare industry rules and regulations, including HIPAA, False Claims Act, Fair Debt Collections Act, and Stark Law
    • Excellent collaboration and organizational skills
    • Effective oral and written communication skills with audience adaptability
    • Ability to work autonomously
    • Establish and maintain effective working relationships with partner practices, insurance payers, EHR vendors, internal Aledade stakeholders, and co-workers
    • Ability to use good judgment and critical thinking skills; ability to identify and resolve problems promptly
    • Ability to work with diverse populations


    Education & Experience:
    • High School Diploma or GED required
    • bachellor's degree in health-related services preferred
    • Minimum 10 years’ experience of billing and coding experience in an outpatient physician practice, ambulatory care setting, or other health-related enterprise, with solid comprehension of coding guidelines.
    • Certified Professional Coder (CPC) required, Certified Risk Adjustment (CRC) nice to have


    Physical Requirements:
    • Prolonged periods of sitting at a desk and working on a computer


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    Who We Are:

    Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of payers, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives, and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.


    What Does This Mean for You?

    At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.


    In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:

    Flexible work schedules and the ability to work remotely are available for many roles

    Health, dental and vision insurance paid up to 80% for employees, dependents, and domestic partners Robust time off plan 21 days of PTO in your first year 2 Paid Volunteer Days & 11 paid holidays

    12 weeks paid Parental Leave for all new parents

    6 weeks paid sabbatical after 6 years of service

    Educational Assistant Program & Clinical Employee Reimbursement Program

    401(K) with up to 4% match

    Stock options

    And much more!


    At Aledade, we don’t just accept differences, we celebrate them!   We strive to attract, develop, and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance, and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.


    Privacy Policy: By applying for this job, you agree to Aledade's Applicant Privacy Policy available at  https://www.aledade.com/privacy-policy-applicants

  • 3 Days Ago

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Billing
  • Slalom
  • Hartford, CT FULL_TIME
  • Who You’ll Work With In our Salesforce business, we help our clients bring the most impactful customer experiences to life and we do that in a way that makes our clients the hero of their transformati...
  • 3 Days Ago

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Enrollment Specialist***ONSITE
  • TEEMA
  • East Hartford, CT TEMPORARY
  • Location: East Hartford, CT (Onsite Only)Job Type: Temporary, Full-timeSalary: $19.24/hrWork Type: Temporary 3-4 month contractResponsibilities:Process paper applications for the Summer EBT (Electroni...
  • 2 Days Ago

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Director of Admissions and Enrollment
  • The Archdiocese of Hartford
  • West Hartford, CT FULL_TIME
  • Director of Admissions and Enrollment Northwest Catholic High School – West Hartford, CT Northwest Catholic High School seeks a full-time a creative, energetic, and results-oriented professional to se...
  • 15 Days Ago

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Billing Supervisor
  • Waste Management
  • Windsor, CT FULL_TIME
  • *Must apply on WM.com/Careers to be eligible to proceed! Please reference job number: 2315875* I. Job Summary: Supervises and evaluates billing, data entry, and cash receipt positions. Analyzes and im...
  • Just Posted

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Billing Specialist
  • US Oncology Network-wide Career Opportunities
  • Manchester, CT FULL_TIME
  • OverviewRegional Cancer Care Associates (RCCA) is looking for an exceptional Billing Specialist to join the team. This position is responsible for all claim submissions, which includes verifying accur...
  • Just Posted

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0 Enrollment & Billing Representative jobs found in Hartford, CT area

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Staff Accountant
  • MDD Forensic Accountants
  • West Hartford, CT
  • STAFF ACCOUNTANT Matson, Driscoll & Damico LLP Status: Full Time, Salary Location: Hartford, CT About the Company Tracin...
  • 3/28/2024 12:00:00 AM

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Accounts Payable Specialist
  • Express Employment Professionals - Meriden, CT
  • Meriden, CT
  • Job Description Job Description Accounts Payable Specialist Full Time, Mon-Fri 8a-4:30pm Payrate: $24-$30/hour Responsib...
  • 3/28/2024 12:00:00 AM

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Patient Financial Access Specialist- Op
  • Yale New Haven Health
  • New Haven, CT
  • Overview: To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mi...
  • 3/28/2024 12:00:00 AM

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Billing Representative I -Temp Role
  • Behavorial Health Network, Inc
  • Springfield, MA
  • Join our team of competent and compassionate professionals as a Temp to Hire Billing Representative at Behavioral Health...
  • 3/27/2024 12:00:00 AM

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Billing Representative I-Behavioral Health
  • Behavorial Health Network, Inc
  • Springfield, MA
  • Join our team of competent and compassionate professionals as a Billing Representative at Behavioral Health Network! Bil...
  • 3/26/2024 12:00:00 AM

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Revenue Cycle Supervisor-Behavioral Health
  • Behavorial Health Network, Inc
  • Springfield, MA
  • Join our team of competent and compassionate professionals as a Revenue Cycle Supervisor in the billing program at Behav...
  • 3/26/2024 12:00:00 AM

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Delivery Drivers / General Movers to setup equipment for private event
  • Innovative Inflatables
  • Waterbury, CT
  • Job Description Job Description We are looking for friendly people interested in work delivering bounce houses, and sett...
  • 3/26/2024 12:00:00 AM

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West Springfield, MA Collision Repair Center Parts Associate
  • Balise Motor Sales
  • West Springfield, MA
  • Job Details Job Location Collision Repair Center West Springfield - West Springfield, MA Description Collision Center Pa...
  • 3/26/2024 12:00:00 AM

Hartford is the capital city of Connecticut. It was the seat of Hartford County until Connecticut disbanded county government in 1960. The city is nicknamed the "Insurance Capital of the World", as it hosts many insurance company headquarters and is the region's major industry. It is the core city in the Greater Hartford area of Connecticut. Census estimates since the 2010 United States Census have indicated that Hartford is the fourth-largest city in Connecticut, behind the coastal cities of Bridgeport, New Haven, and Stamford. Hartford was founded in 1635 and is among the oldest cities in th...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Enrollment & Billing Representative jobs
$36,848 to $46,832
Hartford, Connecticut area prices
were up 1.7% from a year ago

Enrollment & Billing Representative in Boca Raton, FL
Showing up in person often demonstrates determination and initiative that most employers will find alluring in a potential representative.
February 13, 2020