Job Information
Nuvance Health Financial Services Administrator in Danbury, Connecticut
Description
At Nuvance Health, we enjoy the benefits of a two-state system as we cultivate an inclusive culture where everyone feels welcomed, respected and supported. Together, we are a team of 15,000+ strong hearts and open minds. If you share our values of connected, personal, agile and imaginative, we invite you to discover what’s possible for you and your career.
Danbury Hospital, a 456-bed acute care hospital, has been providing award-winning, personalized patient care to the people of Western Connecticut for 140 years. Our specialty areas of excellence include a Level III NICU, a certified Thrombectomy-Capable Stroke Center, and compassionate psychiatric care, including a partial-hospitalization program.
Our accolades include the following:
The Leapfrog Group - Grade A for quality and patient safety
U.S. News & World Report - High performance in heart failure treatment
Healthgrades - One of America’s 50 Best Hospitals
Surgical Review Corporation (SRC) - Robotic Center of Excellence
Joint Commission - Gold seal of approval in spine surgery
At Danbury Hospital, we take great pride in our team members and their passion for providing the best care possible—always with heart. For many of our team members, that care extends beyond the walls of our hospital. We volunteer at local non-profits and participate in community initiatives and events. Our dedication to the health and well-being of our entire community makes this a truly special place to work.Summary:
Under the direction of the Manager, the Behavioral Health (BH) Financial Services Administrator plays a crucial role in supporting the Crisis Intervention team by managing patient financial services and reimbursement processes. This includes obtaining proper documentation in the patients� chart justifying the need for treatment, obtaining insurance prior authorizations for psychiatric hospitalizations, coordinating and submitting claims appeals, and overseeing the retro review and appeals process to prevent denials and revenue loss. The Administrator works closely with insurance providers, hospital staff, and patients to ensure timely and accurate financial approvals, ultimately facilitating access to critical mental health services while optimizing reimbursement outcomes.
Responsibilities:
Denial Management-Focuses on preventing claim denials by verifying accuracy, resolving issues, and collaborating with payors and internal teams for timely reimbursement. Tracks trends and recommends process improvements
*Insurance Verification: *Confirms patient insurance eligibility, processes payor requirements, and secures billing details through online portals or direct communication.
*Authorization & Pre-Certification: *Initiates and obtains prior authorizations, pre-certifications, and referrals using the EMR system to ensure compliance with payor policies.
Clerical & Documentation:
Maintains accurate records, processes necessary correspondence, and updates patient insurance coverage for billing efficiency.
*Team Collaboration: *Coordinates with clinical and administrative staff to ensure accurate and timely submission of patient information to payors.
*Training & Support- *Educate clinical/support staff on financial processes and insurance portals and maintain reimbursement continuity.
Appeals and Denials- Works directly with the finance team to complete retro-authorizations, appeals, and denials in a timely and efficient manner to obtain and recover revenue.
Meetings-Actively participates in daily safety huddles, inpatient psychiatric touchpoint, and weekly longer length of stay meetings in an effort to reduce and eliminate revenue loss from denials.
Compliance & Other Duties- Ensures adherence to regulatory requirements and performs additional tasks as assigned.
Maintains and Models Nuvance Health Values.
Demonstrates regular, reliable, and predictable attendance.
Performs other duties as required.
Other Information:
Position requires knowledge of all aspects of responsibilities of the CBO; Basic knowledge of applicable federal, state laws and regulations; well-developed verbal and written communication skills; Excellent analytical and problem solving skills; Strong working knowledge of payor rules and regulations; Knowledge of hospital billing; Demonstrated ability to manage multiple and complex tasks; Demonstrated ability to train and motivate employees; Professional attitude and ability to relate to executive management and patients; Exhibits self-direction, good judgment in handling difficult situations and good organization, time management, interpersonal and conflict resolution skills.
Bachelor's degree preferred. Minimum Experience: three years
Company: Nuvance Health Med Practice CT
Org Unit: 504
Department: DH Inpatient Psych
Exempt: No
Salary Range: $21.49 - $41.73 Hourly
With strong hearts and open minds, we’re pushing past boundaries and challenging the expected, all in the name of possibility. We are neighbors caring for neighbors, working together as partners in health to improve the lives of the people we serve. If you share our passion for the health of our communities, advance your career with Nuvance Health!
We are an equal opportunity employer
Qualified applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other classification protected under applicable Federal, State or Local law.
We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation or our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to ensure that you are considered for current or future opportunities.