Location: New Haven, CT
Cap-Exempt H-1B Position — No lottery required
Working at Yale means contributing to a better tomorrow. Whether you are a current resident of our New Haven-based community, eligible for opportunities through the New Haven Hiring Initiative, or a newcomer, interested in exploring all that Yale has to offer, your talents and contributions are welcome. Discover your opportunities at Yale! **Overview** Under the direction and supervision of the Associate Director and Team Lead/Manager, employee will be responsible for insurance follow-up on denials from Yale Health Plan, Workers Compensation and MVA payers as well as charge review, credit and claim edit work queues. Follow up of denied claims for Yale Medicine and its related specialties and practices. Follow up denials, resolve claim edits and credits for assigned payers following process guidelines established by the Central Business Office management team. Review carrier denials or letters to analyze next steps needed to ensure payment. Review payment history. Review, work and resolve delinquent accounts with supervisor and collection agency. Recommend and implement changes to system and operation procedures. Compose form letters and correspondence used in account receivable activities. Knowledge of appealing denials in order to receive maximum reimbursement for Yale Medicine. Write, send and follow up on appeals as appropriate by contacting the carrier, researching carrier policies, review of medical documentation and/or work collaboratively with YM staff to ensure maximum reimbursement. Directly communicate with third party insurance carriers, patients, and other listed payers in order to investigate payment/reimbursement delays for billed charges, for both primary and secondary claims. Respond to requests from insurance carriers, Yale Medicine clinical departments and/or patients for supporting documentation necessary in order to obtain maximum reimbursement. Work closely with other centralized and non centralized units within the Business Office to resolve ou