Third Party Risk Manager Jobs in Wolcott, CT (NOW HIRING)

W ork where every moment matters.
Every day, more than 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.
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.
Position Summary:
Responsible for the daily operations of an Accounts Receivable (AR) Follow Up team, tasked with timely and accurate collection of third-party revenue cycle activities associated with outstanding insurance claims across all Hartford HealthCare Hospitals, Medical Group and Homecare to insure optimal revenue cycle performance. The Supervisor is responsible for resolving unpaid third-party balances on $550+ million in active inventory and provides leadership to team leads and staff including management of human resources, vendors, and client relations.
This position reports directly to the Manager of Patient Financial Services Accounts Receivables and works closely with other management and staff throughout the organization. Keeps abreast of all regulations and standards to ensure compliance with governmental/regulatory agencies or third-party payers. Assisting the organization to comply with all federal/state guidelines.
Responsible for ensuring high quality, cost-effective products or services are delivered in support of the HHC core values, strategic plan and established Patient Financial Services goals and objectives.
Provides leadership to the team leads and staff including management of human resources, vendors and client relations through project management, relationship building and collaboration and organizational awareness.
Supports the HHC core values, strategic plan and established Patient Financial Services goals and objectives.
Position Responsibilities:
Key Areas of Responsibility
1. Responsible for supervision of revenue cycle AR team activities associated with timely resolution of outstanding insurance claims.
2. Contributes to decisions that impact workflows effecting timely resolution of insurance claims and assists with implementation.
3. 3.Responsible for the timely realization of payment for active inventory, resolution of denials, overseeing the effective appeals of these claims and protecting against bad debt in this endeavor.
4. Participates in the supervision of vendor relationships and monitors performance.
5. Provides support for other ad hoc analyses and projects as needed
6. Demonstrates H3W Leadership Behaviors.
7. Supports and assists the Manager of Accounts Receivables in maintaining the operations of the Accounts Receivable department.
8. Understands the daily defined function, by performing the work of the function, as required (very minimal).
9. Works with leadership team to develop, implement and monitor meaningful goals and objectives for the department that align with the strategic direction of the organization and industry best practice metrics. Models the effective efficient operation of the unit by, providing clear and specific goals and timely feedback.
10. Monitors, tracks and supervises team's productivity and quality benchmarks and targets. Coaches and mentors' staff regarding productivity and quality. Implements individual performance expectations and coaches, develops and evaluates performance to enable employees to be successful in contributing to the achievement of individual and workgroup objectives.
11. .Effectively and continually communicates with staff, management and customers to facilitate the flow of information. Continually strives to improve quality and productivity by identifying improvement opportunities and recommending and implementing changes where there are opportunities for improvement
12. Actively seeks opportunities to model teamwork through collaboration both within and outside the workgroup in support of the organization's objectives.
13. Evaluates team's daily workload and adjusts schedules and account assignment accordingly. Communicates issues, resources or other needs, and changes to the manager and/or other leadership as appropriate. Communicates daily work plan to the team. Monitors progress throughout the day and adjusts work assignments accordingly. Assures that all assignments due are completed on time.
14. Supervises general HR related issues, this includes annual performance reviews, implementing HR policies, approving PTO and hiring staff. Works with employees on professional development and training opportunities. Manages teams time and attendance; including scheduling, review and approval of time off requests, entering and adjusting timekeeping in Kronos, and tracking of attendance in accordance with policy.
15. Develops and maintains a training and onboarding plan for new staff members joining the department.
16. Assumes responsibility for self-improvement in collaboration with superior.
17. Maintains effective positive customer service, ensuring the needs are met and educating staff on the importance of quality customer service.
Working Relationships:
This Job Reports To: Manager AR Follow-up
Job Title(s) of HHC positions reporting to this Job: Direct supervision of AR Team Lead and AR Collections Specialists in their efforts to review and resolve issues related to insurance claim denials, no response claims and payment variances including underpayments and overpayments. Averages 10+ FTEs as direct reports. Responsible for time and attendance tracking, management, and approval bi-monthly. Responsible for annual performance reviews and develops and implements performance improvement plans where appropriate. Interviews and makes hiring decisions.
Number- Direct Reports: 10+
Number- Indirect Reports : 0
If applicable, describe nature of supervision of any External vendors, contractors, affiliate organizations, etc.: Supervises accounts receivables engagements with small balance, out of state Medicaid and credit vendors as needed.
Qualifications:
Requirements and Specifications:
Education
• Minimum: Associate's degree in health care administration, business management or finance or equivalent healthcare revenue cycle experience.
• Preferred: Bachelor's degree in health care administration, business management or finance or equivalent healthcare revenue cycle experience.
Experience
• Minimum: 3 - 4 years supervisory experience in a facility or professional medical billing and/or accounts receivables setting.
• Preferred: 5+ years supervisory experience in health care revenue cycle billing and/or AR follow up & denials.
Licensure, Certification, Registration
• American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) certification
Knowledge, Skills and Ability Requirements
• Epic experience and working knowledge of Resolute Hospital and Professional billing modules preferred
• Knowledge of state and federal regulations as they pertain to billing processes and procedures
• Knowledge of insurance claim processing and third-party reimbursement
• Knowledge and detailed understanding of all negotiated agreements
• Demonstrated leadership in establishing and achieving goals
• Ability to communicate effectively both orally and in writing, strong computer and math skills required
• Skill in problem solving in a variety of settings
• Skill in time management and project management
• Ability to work efficiently under pressure
• Ability to operate a computer and related applications such as Word, Excel, PowerPoint, etc.
• Ability to apply appropriate supervisory, management and leadership techniques in an operational setting
• Ability to work independently and take initiative
• Ability to demonstrate a commitment to continuous learning and to operationalize that learning
• Ability to deal effectively with constant changes and be a change agent
• Ability to deal effectively with difficult people and/or difficult situations
• Ability to willingly accept responsibility and/or delegate responsibility
• Ability to set priorities and use good judgment for self and staff
• Ability to exercise independent judgment in unusual or stressful situations
• Ability to establish and maintain effective working relationships.
• Strong leadership skills and ability to motivate direct reports
• Must have PC skills including Word, Excel, Power Point
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 employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.